Primary tracheal tumors: experience with 14 resected patients

Objective: Primary tracheal tumors are rare. Management includes interventi onal endoscopy, surgery and radiotherapy. Methods: Between 1987 and 1996, 1 4 patients treated by resection and reconstruction of the trachea and bifur cation for primary tracheal tumors were retrospectively analyzed. Results: The most common histological finding was adenoid cystic carcinoma (n = 7), followed by a squamous cell carcinoma (n = 2), a mucoepidermoid carcinoma ( n = 2), a carcinoid tumor (n = 1) and two benign tumors (xanthogranuloma, p leomorphic adenoma). Various reconstruction techniques were used and one pr osthesis was implanted. Eight of the patients required preoperative Nd-YAG laser recanalisation. Six were treated by postoperative external beam radio therapy, in three casts combined with endoluminal brachytherapy. Two major postoperative wound-healing impairment at the anastomosis occurred. Four mi nor wound-healing disorders were successfully treated by interventional end oscopy. Two patients died postoperatively with mediastinitis respectively w ith bilateral pneumonia. A local recurrence was observed in only two cases. At the last follow-up in January 1998, nine patients were still alive. We observed five long-term survivors (>6 years) with an adenoid cystic carcino ma or mucoepidermoid carcinoma. Conclusions: Extensive segmental resection of the trachea is the treatment of choice for primary malignant and occasio nally fur benign tracheal tumors. Interventional endoscopy is a part of mod ern tracheal surgery. (C) 2001 Elsevier Science B.V. All rights reserved.