HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Thomas R. J. Todd Timothy L. Winton F. Griffith Pearson Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Maziak, D. E. Articles by Pearson, F. G. Search for Related Content PubMed PubMed Citation Articles by Maziak, D. E. Articles by Pearson, F. G.

J Thorac Cardiovasc Surg 1996;112:1522-1532
© 1996 Mosby, Inc.

GENERAL THORACIC SURGERY

ADENOID CYSTIC CARCINOMA OF THE AIRWAY: THIRTY-TWO-YEAR EXPERIENCE

From the University of Toronto, The Toronto Hospital, Departments of Thoracic Surgery and Pathology, Toronto, Ontario, Canada.

Received for publication May 6, 1996 revisions requested May 28, 1996; revisions received Sept. 4, 1996 accepted for publication Sept. 5, 1996. Address for reprints: F. G. Pearson, MD, The Toronto General Hospital, 200 Elizabeth St., EN10-233, Toronto, Ontario, Canada M5G 2A1.

Abstract

Methods: We have reviewed our experience in 38 patients with adenoid cystic carcinoma of the upper airway seen between 1963 and 1995. The mean age was 44.8 years (15 to 80 years) with a male/female ratio of 1:1.1. Thirty-two of the 38 patients were treated by resection and reconstruction (primary anastomosis 28; Marlex mesh prosthesis 4). Twenty-six of the 32 patients undergoing resection received adjuvant radiotherapy. Six patients with unresectable tumors were treated primarily with radiotherapy only.
Results: Pathologic examination revealed local invasion beyond the wall of the trachea in all patients. In a majority, microscopic extension was found in submucosal and perineural lymphatics, well beyond the grossly visible or palpable limits of the tumor. Lymphatic metastases were relatively uncommon, occurring in only five of 32 (19%) patients undergoing resection. Metachronous hematogenous metastases occurred in 17 of 38 patients (44%). Thirteen of these 38 patients (33%) had pulmonary metastases. Sixteen of 32 resections were complete and potentially curative. There were two deaths within 30 days of operation. The mean survival in the 14 patients undergoing complete resection was 9.8 years (12 months to 29 years). Sixteen of 32 resections were incomplete (residual tumor at the airway margin on final pathologic examination), with one operative death occurring in this group. The mean survival in the 15 surviving patients was 7.5 years (4 months to 21 years). Six patients were treated with primary radiation only and had a mean survival of 6.2 years (2 months to 14.3 years). In the patients with pulmonary metastases, mean survival was 37 months (4 months to 7 years) from the time of diagnosis of the pulmonary metastasis until their death.
Conclusion: Adenoid cystic carcinoma of the upper airway is a rare tumor, which is locally invasive and frequently amenable to resection. Although late local recurrence after resection is a feature of this tumor (up to 29 years), excellent long-term palliation is commonly achieved after both complete and incomplete resection. There was a small difference in survival between patients having complete and incomplete resection. Long periods of control can be obtained with radiotherapy alone. The best results, in this series of patients, were obtained by resection. Adjuvant radiotherapy is assumed to favorably influence survival. (J THORAC CARDIOVASC SURG 1996;112:1522-32)

This article has been cited by other articles:

				A. Sayar, M. Metin, O. Solak, A. Turna, S. Alzafer, and T. Ece A New Surgical Techique for Adenoid Cystic Carcinoma Involving Tracheal Carina Asian Cardiovasc Thorac Ann, September 1, 2005; 13(3): 280 - 282. [Abstract] [Full Text] [PDF]

				H. A. Gaissert, H. C. Grillo, M. B. Shadmehr, C. D. Wright, M. Gokhale, J. C. Wain, and D. J. Mathisen Long-Term Survival After Resection of Primary Adenoid Cystic and Squamous Cell Carcinoma of the Trachea and Carina Ann. Thorac. Surg., December 1, 2004; 78(6): 1889 - 1897. [Abstract] [Full Text] [PDF]

				H. C. Grillo Development of tracheal surgery: a historical review. Part 2: treatment of tracheal diseases Ann. Thorac. Surg., March 1, 2003; 75(3): 1039 - 1047. [Full Text] [PDF]

				H. C. Grillo Development of tracheal surgery: a historical review. Part 1: techniques of tracheal surgery Ann. Thorac. Surg., February 1, 2003; 75(2): 610 - 619. [Full Text] [PDF]

				K. Hazama, S. Miyoshi, A. Akashi, T. Yasumitsu, H. Maeda, K. Nakamura, H. Tada, and H. Matsuda Clinicopathological investigation of 20 cases of primary tracheal cancer Eur. J. Cardiothorac. Surg., January 1, 2003; 23(1): 1 - 5. [Abstract] [Full Text] [PDF]

				P. Schneider, J. Schirren, T. Muley, and I. Vogt-Moykopf Primary tracheal tumors: experience with 14 resected patients Eur. J. Cardiothorac. Surg., July 1, 2001; 20(1): 12 - 18. [Abstract] [Full Text] [PDF]

				D. J. Mathisen The trachea Ann. Thorac. Surg., June 1, 2001; 71(6): 2075 - 2076. [Full Text] [PDF]

				A. Aggarwal, S. Tewari, and A. C. Mehta Successful Management of Adenoid Cystic Carcinoma of the Trachea by Laser and Irradiation Chest, July 1, 1999; 116(1): 269 - 270. [Full Text] [PDF]