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The Annals of Thoracic Surgery, Vol 49, 69-77, Copyright © 1990 by The Society of Thoracic Surgeons
HC Grillo and DJ Mathisen
One hundred ninety-eight patients with primary tracheal tumors were
evaluated in 26 years. One hundred forty-seven tumors were excised (74%):
132 (66%) by resection and primary reconstruction, seven by laryngotracheal
resection or cervicomediastinal exenteration, and eight by staged
procedures. Eleven more were explored. Forty-four squamous cell carcinomas
were resected, 60 adenoid cystic, and 43 assorted tumors, benign and
malignant. Eighty-two patients underwent tracheal resection with primary
reconstruction, and 50 had carinal resection and reconstruction. Surgical
mortality for resection with primary reconstruction was 5%, with one death
after tracheal and six after carinal repair. Six patients had stenosis
after tracheal or carinal resection; all underwent reresection
successfully. Nearly all patients with squamous or adenoid cystic carcinoma
were irradiated postoperatively. Twenty of 41 survivors of resection of
squamous cell carcinoma are living free of disease (some for more than 25
years), 39 of 52 with adenoid cystic carcinoma (up to nearly 19 years), and
35 of 42 with other lesions (5 lost to follow-up). Comparison of length of
survival of patients with squamous cell carcinoma and adenoid cystic
carcinoma who are alive without disease with those who died with carcinoma
supports surgical treatment (usually followed by irradiation). Positive
lymph nodes or invasive disease at resection margins appear to have an
adverse effect on cure of squamous cell carcinoma; such an effect is not
demonstrable with adenoid cystic carcinoma.
ARTICLES
Primary tracheal tumors: treatment and results
General Thoracic Surgical Unit, Massachusetts General Hospital, Boston 02114.
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