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

View Article: PubMed Central - PubMed

ABSTRACT

Background: Tracheal cancers (TC) are rare and treatment results that are reported are typically not satisfactory. The purpose of this research was 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: The Regional Cancer Database and the Hospital Database were searched for patients with tracheal neoplasms. Fifty-eight of 418 patients identified initially, met the inclusion criteria (primary TC with confirmed histology and complete treatment records). Standard statistical tests were used.

Results: Squamous cell carcinoma (SCC; 63.8%) and adenoid cystic carcinoma (ACC; 15.5%) were the most commonly diagnosed histological types of TC. Radiotherapy was delivered in 48 cases, surgery or endoscopic resection in 20, and chemotherapy in 14. TC was diagnosed as a second cancer in 10 patients, in 1 patient it occurred prior to the lung cancer, and in 1 was diagnosed simultaneously. During the median follow-up of 12.7 months, 85.5% of the patients died because of the disease. Local recurrence occurred in 17% cases. In univariate analysis, patients with ACC had statistically better five-year overall survival (77.8%) than those diagnosed with SCC (8.4%, p = 0.0001). Radiotherapy, performance status and haemoptysis were factors significantly influencing overall survival (OS) in the multivariate analysis. Among patients who were not treated surgically, 15–26% were found to constitute additional surgery candidates, depending on the selection criteria.

Conclusions: The diagnostic workup should be focused on the identification of TC patients suitable for invasive treatment and radiotherapy. Respiratory system cancer survivors can be considered a risk group for tracheal cancer. Radiotherapy constitutes an important part of the treatment of patients with TC.

No MeSH data available.


Related in: MedlinePlus

Overall survival of patients with adenoid cystic carcinoma (ACC) and squamous cell carcinoma (SCC).
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j_raon-2016-0046_fig_002: Overall survival of patients with adenoid cystic carcinoma (ACC) and squamous cell carcinoma (SCC).

Mentions: In the univariate analysis, patients with ACC had statistically better overall survival (OS) than those diagnosed with SCC (p = 0.0001). Five-year OS for ACC and SCC were 77.8% and 8.4% respectively (Figure 2). Patients with performance status of 0 or 1 had better OS than those with performance status of 2. Five-year OS for patients with ECOG 0 and 1 was 36% and 26%, respectively, compared to 0% for patients with ECOG 2 (Figure 3). OS was lower in the group of smokers (p = 0.016). In addition, haemoptysis was a symptom associated with shorter OS (p = 0.049). The presence of other symptoms did not influence the overall survival. Patients who received radiotherapy had better OS (p = 0.026). Excision of the tumour (surgery or endoscopic resection) also had a positive influence on OS (p = 0.030). The use of systemic treatment was not proven efficient (p = 0.361). The variables significantly influencing the OS in the Kaplan-Meier analysis were then included into a multivariate analysis which confirmed significant influence of radiotherapy (p = 0.013), performance status (p = 0.033) and haemoptysis (p = 0.003) on OS. The histological type of cancer and surgical excision of the tumour did not reach the threshold of statistical significance (p = 0.068, and p = 0.324, respectively). The multivariate analysis did not confirm the independent significance of the smoking status (p = 0.109).


Tracheal cancer – treatment results, prognostic factors and incidence of other neoplasms
Overall survival of patients with adenoid cystic carcinoma (ACC) and squamous cell carcinoma (SCC).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC5120581&req=5

j_raon-2016-0046_fig_002: Overall survival of patients with adenoid cystic carcinoma (ACC) and squamous cell carcinoma (SCC).
Mentions: In the univariate analysis, patients with ACC had statistically better overall survival (OS) than those diagnosed with SCC (p = 0.0001). Five-year OS for ACC and SCC were 77.8% and 8.4% respectively (Figure 2). Patients with performance status of 0 or 1 had better OS than those with performance status of 2. Five-year OS for patients with ECOG 0 and 1 was 36% and 26%, respectively, compared to 0% for patients with ECOG 2 (Figure 3). OS was lower in the group of smokers (p = 0.016). In addition, haemoptysis was a symptom associated with shorter OS (p = 0.049). The presence of other symptoms did not influence the overall survival. Patients who received radiotherapy had better OS (p = 0.026). Excision of the tumour (surgery or endoscopic resection) also had a positive influence on OS (p = 0.030). The use of systemic treatment was not proven efficient (p = 0.361). The variables significantly influencing the OS in the Kaplan-Meier analysis were then included into a multivariate analysis which confirmed significant influence of radiotherapy (p = 0.013), performance status (p = 0.033) and haemoptysis (p = 0.003) on OS. The histological type of cancer and surgical excision of the tumour did not reach the threshold of statistical significance (p = 0.068, and p = 0.324, respectively). The multivariate analysis did not confirm the independent significance of the smoking status (p = 0.109).

View Article: PubMed Central - PubMed

ABSTRACT

Background: Tracheal cancers (TC) are rare and treatment results that are reported are typically not satisfactory. The purpose of this research was 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: The Regional Cancer Database and the Hospital Database were searched for patients with tracheal neoplasms. Fifty-eight of 418 patients identified initially, met the inclusion criteria (primary TC with confirmed histology and complete treatment records). Standard statistical tests were used.

Results: Squamous cell carcinoma (SCC; 63.8%) and adenoid cystic carcinoma (ACC; 15.5%) were the most commonly diagnosed histological types of TC. Radiotherapy was delivered in 48 cases, surgery or endoscopic resection in 20, and chemotherapy in 14. TC was diagnosed as a second cancer in 10 patients, in 1 patient it occurred prior to the lung cancer, and in 1 was diagnosed simultaneously. During the median follow-up of 12.7 months, 85.5% of the patients died because of the disease. Local recurrence occurred in 17% cases. In univariate analysis, patients with ACC had statistically better five-year overall survival (77.8%) than those diagnosed with SCC (8.4%, p = 0.0001). Radiotherapy, performance status and haemoptysis were factors significantly influencing overall survival (OS) in the multivariate analysis. Among patients who were not treated surgically, 15–26% were found to constitute additional surgery candidates, depending on the selection criteria.

Conclusions: The diagnostic workup should be focused on the identification of TC patients suitable for invasive treatment and radiotherapy. Respiratory system cancer survivors can be considered a risk group for tracheal cancer. Radiotherapy constitutes an important part of the treatment of patients with TC.

No MeSH data available.


Related in: MedlinePlus