Clinical analysis of 74 cases of primary tracheal adnoid cystic carcinoma

Objective To analyze the primary tracheal adnoid cystic carcinoma. Methods Seventy-four patients with primary tracheal adnoid cystic carcinoma were confirmed by pathology or cytology with a median age of 43.Cough was the most common symptom.T stage classification showed T1 in 8 cases (10.8%),T2 in 19 (25.7%),T3 in 23 (31.1%) and T4 in 24 (32.4%).Mediastinal lymph node metastasis was found in 8 cases,distance metastasis in 2.Sixty-two patients (83.8%) underwent surgery,with R0 resection in 27 and R1 or R2 resection in 35,among whom 24 received surgery only,12 received radiotherapy only and 38 received combined therapy. Results Recurrence or metastasis occurred in 43 patients (58.1%),including 20 recurrence,17 distance metastasis and 6 with both recurrence and distance metastasis.All distance metastases were in lung except 2.The median time of first recurrence or distance metastasis was 32 months and that for the second and third were 12 and 6 months.The survival rates of 5-year and 10-year were 69.7% and 35.9%,with the median survival time of 55 months. Conclusions The primary tracheal adnoid cystic carcinoma has a generally good prognosis. The tumor length,T stage and treatment including surgery may be the prognostic factors. The patients with recurrence or distance metastasis may survive longer if they receive active treatment. Lung metastasis is the most common distance metastasis.