Clinical Characteristics, Treatment and Prognosis of Primary Tracheal Adenoid Cystic Carcinoma: A Multicenter Retrospective Study

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BACKGROUND: Tracheal adenoid cystic carcinoma (TACC) is a rare salivary gland malignant tumor. Previous studies mainly focused on surgery, radiation, and chemotherapy. The purpose of this study is to describe more clinical characteristics, treatments, and overall survival (OS) of TACC. METHODS: Retrospectively analyzed TACC patients from two medical institutions and the SEER database from January 2010 to December 2021. Survival curves were drawn using the Kaplan-Meier method, and the effects of prognosis were analyzed by multivariate COX regression and AFT. The endpoint of the study was overall survival (OS). RESULTS: One hundred fifty TACC patients were enrolled (DZM 11, EG 64, SEER 75), and the 5- and 10-year survival rate was 70.62% and 35.80%, with a median survival time of 98 months. Lymph node status (yes) is an independent risk factor for TACC (HR = 3.020, 95% CI = 1.419-6.426, p = 0.004), and surgery is an independent protective factor (HR = 0.293, 95% CI = 0.146-0.587, p = 0.001). The AFT yielded similar results. In subgroup analysis of 63 non-surgical patients, lymph node status (Yes) (HR = 3.511, 95% CI = 1.498-8.229, p = 0.004), and tumor longitudinal diameter range (TLDR) > 1 (HR = 2.975, 95% CI = 1.360-6.506, p = 0.006) are independent risk factors, while Targeted Therapy (HR = 0.248, 95% CI = 0.096-0.637, p = 0.004) is an independent protective factor. CONCLUSION: Lymph node status and TLDR are prognostic factors of TACC. Surgery is associated with prolonged survival of TACC. Targeted therapy may be associated with improved survival among non-surgical TACC patients. TRIAL REGISTRATION: ChiCTR2400083551.

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