Long-term results of surgery for adenoid cystic carcinoma of the trachea and bronchi

Aims: Over a period of 26 years, 16 patients (9 women, 7 men) underwent surgery for primary adenoid cystic carcinoma (ACC) of the trachea and bronchi. The median age at diagnosis was 41.4 years (range 25–67). Nine tumours were located in the bifurcational area, five in the trachea, one in the middle-lobe bronchus and one in the parenchyma of the left lower lobe. Methods: Surgical procedures were as follows: three tracheal transversal resections; five resections of the distal trachea including the bifurcational region, followed by bifurcational reconstruction; two right-sleeve pneumonectomies; three left-sleeve pneumonectomies; two lobectomies; and one explorative sternotomy. Results: Eleven patients were available for follow-up at least 5 years after surgery. Three of these patients (27%) had local recurrence 155 ± 30 (range 120–175) months after surgery. Distant metastases occurred in six patients (55%) after a median time interval of 96 ± 68 (range 24–180) months after surgery. Conclusions: Five-year and 10-year survivals were excellent, 79 and 57% respectively, but the long-term outcome was poor due to late local recurrences and late metastatic spread. It is not yet certain whether a cure can really be achieved in ACC.