Eastern Cardiothoracic Surgical Society

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One Thousand Cases of Primary Malignant Tracheal Tumors; Characteristics and Outcomes
Mirza Zain Baig1, Joanna Weber1, Faiz Y. Bhora2.
1Health Quest, Danbury, CT, USA, 2Health Quest, Poughkeepsie, NY, USA.

OBJECTIVE: Primary malignant tracheal tumors (PMTT) are rare and therefore do not have a standardized approach to their treatment. We plan to investigate PMTT using a large population database to determine treatment modalities as well as factors associated with outcomes.
METHODS: The Surveillance, epidemiology and end results (SEER) database was queried between 1973 to 2016 for PMTT. Demographic information, tumor characteristics, treatment and survival outcomes were investigated.
RESULTS: One thousand cases were analyzed. Majority of the patients were male (57.1%) and white (81.9%). The average age was 62.25 (14.67). Squamous cell carcinoma (SCC) was the predominant subtype (56.3%) followed by Adenoid cystic carcinoma (ACC) (19%). Most common treatment strategies included radiation alone (26.2%), surgery plus radiation (23%), chemotherapy plus radiation (18%) and surgery alone (17.8%). The overall 5-year survival was 27.1% and median survival was 23 months. Patients with SCC had 5-year survival of 16.3% and median survival of 14 months. Patients with ACC had 5-year survival of 58.9% and median survival of 113 months. SCC had the best median survival when treated with surgery plus radiation (26 months) whereas ACC had best outcomes when treated with surgery alone (218 months). Cox proportional hazards identified female gender, advanced age, white ethnicity, large cell histology, radiation and chemotherapy as negative predictors of outcome.
CONCLUSIONS: We present the largest dataset on PMTT. In this study patients with SCC had best outcomes when treated with surgery plus radiation whereas patients with ACC had the best results with surgery alone.


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