Primary carcinomas of the trachea are rare tumors, occurring at a rate of 2.6 new cases per 1,000,000 people per year. This study investigates the large observational cohort of patients recorded in the NCI Surveillance, Epidemiology, and End Results (SEER) 1973-2004 database, and provides information regarding epidemiology, treatment, and prognosis.
The SEER database was investigated, and all patients for whom primary tracheal carcinoma was the first and only cancer were investigated. Demographic information was investigated. The cohort was analyzed for variables effecting survival, including age, gender, race, histology, extent of disease, extent of surgery, use of radiation, and year of diagnosis.
Between 1973 and 2004, 578 cases of primary tracheal carcinomas were reported in the SEER database. There were 322 men (55.7%) and 256 women (44.3%). Squamous cell carcinoma was the predominant histology, representing 259 tumors (44.8%). Adenoid cystic carcinoma (ACC) was the second most common tumor (16.3%). Localized, regional and distant disease was found in 140 (24.2%), 212 (36.7%), and 108 (18.7%), respectively. Twenty percent of the patients did not undergo staging. Patients with localized disease had a better prognosis than those with regional (P = 0.001) or distant disease (P = <0.001).A significant fraction of patients did not receive cancer directed local therapy; 34.3% did not undergo surgery and 29.1% did not receive any kind of radiation therapy. There was a statistically significant improved survival for patients who underwent any type of surgery in comparison with patients who did not undergo cancer directed surgery. There was no statistical benefit for patients who underwent radiation therapy.General overall 5-year survival for all patients was 27.1% (95% CI: 23.1-33.3%). Patients with localized disease had a better outcome than patients with regional or distant disease with an overall 5-year survival of 46% (95% CI: 37.3%-55.8%). Squamous cell carcinoma tumors had worse outcomes than any other histologic type, with a 5 year overall survival of 12.6% (95% CI: 8.4-17.6%). In contrast, 5-year overall survival for AACs was relatively good at 74.3% (95% CI: 63.1-82.5). For localized disease, 5-year survival was 24.7% (95% CI: 12.8-38.7%) for squamous cell carcinoma versus 90.5% (95% CI: 73.3-96.8%) for ACCs (P < 0.001).
Primary tracheal tumors are very uncommon; squamous cell carcinoma is the most common histologic type, followed by ACCs. General 5-year overall survival is poor, though localized disease has better survival when compared with regional or distant disease. There is a remarkable difference in survival between squamous cell carcinoma and ACC.
"The incidence of primary tracheal carcinoma is 0.10 to 0.26 per 100,000 persons [1-5], accounting for 0.1–0.4% of total malignancy . Adenoid cystic carcinoma (ACC) is the second most common type of primary tracheal tumors after squamous cell carcinoma (SCC) . "
[Show abstract][Hide abstract] ABSTRACT: Primary tracheal tumors occur infrequently, accounting for less than 0.1% of all tumors. Adenoid cystic carcinoma (ACC) is the second most common type of malignancy of the trachea after squamous cell carcinoma (SCC). Little has been reported on the risk factors for tracheal ACC. The purpose of this study is to describe a case of tracheal ACC in a patient who had been exposed to rubber fumes, and to review the relationship between tracheal ACC and rubber fumes.
A 48-year-old man who had been experiencing aggravation of dyspnea for several months was diagnosed as having ACC of the trachea on the basis of a pathologic examination of a biopsy specimen obtained via laser microscopy-guided resection. The patient had been exposed to rubber fumes for 10 years at a tire manufacturing factory where he worked until ACC was diagnosed. His job involved preheating and changing rubber molds during the curing process.
ACC of both the trachea and the salivary glands show very similar patterns with regard to histopathology and epidemiology and are therefore assumed to have a common etiology. Rubber manufacturing is an occupational risk factor for the development of salivary gland tumors. Further, rubber fumes have been reported to be mutagenic. The exposure level to rubber fumes during the curing process at the patient's workplace was estimated to be close to or higher than British Occupational Exposure Limits. Therefore, tracheal ACC in this case might have been influenced by occupational exposure to rubber fumes.
"Primary carcinomas of the trachea are rare tumors, occurring at a percent of 2.6 new cases per 1,000,000 people per year. Adenoid cystic carcinoma (ACC) was the second most common tumor (16.3%) among primary tracheal cancers.9 As symptoms, pulmonary metastasis are the most common ones but brain, bone, liver, kidney, skin even abdomen and heart metastasis have been reported as well.10 "
[Show abstract][Hide abstract] ABSTRACT: Cancer complicates approximately 0.1% of all pregnancies. Primary tracheal carcinoma is one of very rarely seen tumors and the rate of its being seen makes up approximately % 0.2 of all tumors of respiratory tract. The patient, 28 years old, who has 28-weeks-pregnant, was diagnosed with primary tracheal adenocystic carcinoma. Patient was made operation as thoracotomy and tracheal tumor was removed at the 28(th) week of pregnancy. Patient was delivered with sectio abdominale at the 39(th) week of pregnancy. Primary tracheal adenocystic carcinoma is very rarely seen tumors and it is the first tracheal ACC with pregnancy case in literature to have been detected and surgically treated during pregnancy. We discussed primary tracheal adenocystic carcinoma and tracheal tumors during pregnancy with literature.
[Show abstract][Hide abstract] ABSTRACT: Our study was conducted in patients with primary squamous cell carcinoma of the trachea and adenoid cystic carcinoma (191) (radical surgery--90; combined treatment--101). The former pathology was relatively more aggressive. Combined treatment proved more effective as compared with surgery alone (5- and 10-year survival after surgery was 79 and 64%; combined treatment--92 and 79%, respectively).
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