Primary tracheal cancer: A regional cancer center experience

Abstract

Background: Primary tracheal cancers (PTC) are uncommon, and the treatment methods vary considerably. Aim: The aim of the present study was to explore the clinical features, management, and prognosis of PTC in an Indian context. Methods: Nineteen patients of PTC were retrieved from the medical records over a period from January 2013 to December 2019. The clinical profile, histological features, and treatment details were recorded and outcomes are analyzed in terms of progression-free survival (PFS) and overall survival (OS). Results: Histological distribution for the cases were squamous cell carcinoma (SCC) (n = 12), adenoid cystic carcinoma (ACC) (n = 6) and small cell carcinoma (n = 1). All the patients were symptomatic. SCC was located more (7 out of 12 cases; 58.33%) in the lower third of the trachea than ACC (2 out of 6 cases; 33.33%). At initial diagnosis, five patients had metastatic disease and all the cases were of SCC histology (4 cases treated with palliative chemotherapy and 1 case received best supportive care). Among nonmetastatic cases (n = 14), 4 patients (SCC: 2; ACC: 2) were considered for primary surgery and the rest were considered unresectable and treated with other modalities except one case of ACC who did not come for treatment after diagnosis. The median PFS for ACC patients was higher than SCC (32 months vs. 10 months; P = 0.013). The median OS for ACC was higher than SCC cases (34.5 months vs. 11.2 months; P = 0.009). Conclusions: SCC followed by ACC are the most common histology types for PTC. ACC has a better prognosis compared to SCC.