Tracheal cancer – treatment results, prognostic factors and incidence of other neoplasms

Abstract

Background

Tracheal cancers (TC) are rare, often misdiagnosed as pulmonary disorders and reported treatment results are not satisfactory.

Purpose

Assessment of the results of treatment of TC patients, identification of potential additional surgery candidates, evaluation of prognostic factors, and assessment
of the occurrence of other malignancies.

Patients and methods

Regional Cancer Database and Hospital Database were searched for patients with tracheal neoplasms. Among 418 patients we found 58 cases who met inclusion criteria. Their medical records were reviewed to find second malignancies and potential surgical candidates. In statistical analysis Kaplan-Maier method, log rank test and Cox proportional hazard model were used.

Results

Squamous cell carcinoma (SCC) was diagnosed in 63.8%, in 15.5% adenoid cystic carcinoma (ACC), and 20.7% had other histological types of cancer. Radiotherapy was employed in 48 cases, surgery or endoscopic resection in 20, and chemotherapy in 14. TC was diagnosed as a second cancer in 11 cases and in 1 before lung cancer.

During median follow-up of 12.7 months 85.5% patients died because of the disease. Local recurrence occurred in 17% cases. Radiotherapy, performance status and hemoptysis were factors significantly influencing overall survival (OS) in multivariate analysis. Among patients who were not treated surgically 15-26% were found
to be additional surgery candidates depending on selection criteria.

Conclusions

The diagnostic workup should be concentrated on identification of TC patients suitable for invasive treatment and radiotherapy. Respiratory system cancer survivors can be considered a risk group for tracheal cancer. The role of chemotherapy requires further investigation.