13例原发性颈段气管腺样囊性癌的手术治疗

国内外很少报道原发性颈段气管腺样囊性癌的外科治疗,本研究探讨13例该类患者外科治疗的有效性。

Surgery for primary adenoid cystic carcinoma of cervical trachea

BACKGROUND & OBJECTIVE: There were few reports about surgery for primary adenoid cystic carcinoma of cervical trachea. This study was designed to evaluate the efficacy of surgical resection of a series of 13 patients with primary adenoid cystic carcinoma of cervical trachea. METHODS: Thirteen patients who underwent surgical resection with biopsy-proven primary adenoid cystic carcinoma of cervical trachea were reviewed retrospectively. RESULTS: Of 13 patients, 6 patients showed that tracheal invasion were more than 40 mm length, 7 less than 40 mm length. Seven patients showed extratracheal invasion, 2 showed distance metastases, and 1 showed metastases in regional lymph nodes. Nine patients were treated with sleeve resection of trachea with primary anastomosis (average length of 34.8 mm resected), of which 3 underwent laryngeal release and 8 reserved laryngeal function; 2 received laryngectomy with end tracheostomy and 2 received partial tracheal resection and a patch of autologous tissue reconstruction. Of 13 patients, 4 patients were treated with complete resection and 9 with incomplete resection alone or combined by postoperative irradiation. No death occurred during operation. Two tracheal stenoses and 1 laryngeal recurrent nerve palsy after operation were observed. Seven patients died after therapy, of which 6 patients failed to local management, 1 case died of distance metastases. The total 5- and 10-year survival rates were 69.2% (9/13) and 50.0% (5/10), respectively. The 5- and 10-year survival rates were 75.0% (3/4) and 75.0% (3/4) for complete resection group, 55.0% (5/9) and 33.0% (2/6) for incomplete resection group, 83.3% (5/6) and 83.3% (5/6) for non-extratracheal invasion group, 57.1% (4/7) and 0% for extratracheal invasion group (P=0.001). CONCLUSION: Sleeve resection of trachea with primary reconstruction is the major treatment of the patients suffering from primary cervical tracheal adenoid cystic carcinoma with the long-term survival and function reservation.