Demographic, Disease, and Treatment Characteristics of Primary Tracheal Cancers.

Background: Primary tracheal cancers (PTCs) are rare neoplasms underreported in the literature. No consensus guidelines exist for the treatment of these cancers and multimodal management of these cancers has not been adequately explored for cases diagnosed over the past 2 decades.

Methods: The Surveillance, Epidemiology, and End Results (SEER) database was queried to identify patients with PTC. Cox proportional hazards and log-rank testing was used to assess the association between demographic and treatment variables and 5-year cause-specific survival (CSS).

Results: Among the 689 identified patients, age < 65 years at diagnosis (hazard ratio [HR] 0.64, p < 0.001), non-squamous cell carcinoma (SCC) histology (HR 0.22, p < 0.001), and treatment with surgery (HR 0.43, p < 0.001) were all associated with increased 5-year CSS. Regarding disease histology, patients with adenoid cystic carcinomas (ACCs) had increased 5-year CSS compared with those with neither SCC nor ACC histology and those with SCC histology (83.4% [76.0%, 90.8%] versus 50.3% [42.5%, 58.1%] and 28.8% [23.2%, 34.4%]; p < 0.001) based on univariate analysis. Despite the improved CSS associated with surgery, 55% of the identified cohort did not undergo surgery, with only 5.5% of these patients having ACC compared with 58% having SCC (p < 0.001).

Conclusions: Age < 65 years, ACC histology, and treatment with surgery were associated with improved 5-year CSS among patients with PTC, although the significant proportion of this group not receiving surgery represents an opportunity for improved outcomes.