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Parshin V.D.

Sechenov First Moscow State Medical University;
National Medical Research Center of Phthisiopulmonology and Infectious Diseases;
Federal Medical Biological Agency

Rusakov M.A.

Sechenov First Moscow State Medical University

Parshin A.V.

Sechenov First Moscow State Medical University

Mirzoyan O.S.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Simonova M.S.

Sechenov First Moscow State Medical University

Simonova M.S.

Sechenov First Moscow State Medical University

Parshin V.V.

Sechenov First Moscow State Medical University

Ursov M.A.

Sechenov First Moscow State Medical University

Surgery of primary tracheal tumors

Authors:

Parshin V.D., Rusakov M.A., Parshin A.V., Mirzoyan O.S., Simonova M.S., Simonova M.S., Parshin V.V., Ursov M.A.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2022;(8): 12‑24

DOI: 10.17116/hirurgia202208112

Views: 4153

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Table of contents

SURGERY OF PRIMARY TRACHEAL TUMORS
SURGERY OF PRIMARY TRACHEAL TUMORS

To cite this article:

Parshin VD, Rusakov MA, Parshin AV, et al. . Surgery of primary tracheal tumors. Pirogov Russian Journal of Surgery. 2022;(8):12‑24. (In Russ.)
https://doi.org/10.17116/hirurgia202208112

Подписка 2025-2 (Pirogov Russian Journal of Surgery)
МСФ на ЯМ
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OBJECTIVE

To determine the main forms of primary tracheal cancer (PTC), to specify the indications for various surgeries in these patients depending on extent and localization of lesion.

MATERIAL AND METHODS

There were 263 PTC patients. Benign tumors were diagnosed in 68 (25.9%) patients, malignancies — in 195 (74.1%) cases. Tracheal cancer includes 3 basic morphological variants — adenocystic cancer (49.7%), carcinoid (18.7%) and squamous cell carcinoma (19.0%). Other forms of malignancies were much less common. We applied endoscopic intraluminal and open surgeries. In malignant PTC, open surgeries were performed in 165 (84.6%) out of 195 patients. Baseline palliative endoscopic treatment was performed in 30 patients. They underwent airway recanalization (with subsequent tracheal stenting in 19 patients). Endoscopic resection was preferred for benign tumors.

RESULTS

Twenty (12.1%) patients died after open surgery, and 1 (3.3%) patient died after endoscopic procedure. Most lethal outcomes occurred in early years of development of tracheal surgery. The causes of mortality were tracheal anastomotic failure in 12 patients, pneumonia in 6 patients, and arterial bleeding in 2 patients. Severe postoperative period was observed in all 3 patients after tracheal replacement with a silicone prosthesis. Long-term treatment outcomes depended on morphological structure of PTC. Favorable results were observed in patients with neuroendocrine tumor (carcinoid), worse outcomes in adenocystic cancer and unfavorable results in squamous cell carcinoma (p<0.0013). Five-year survival rates were 75%, 65.6%, and 13.3%; 10-year survival rates were 75%, 56.2%, and 13.3%, respectively. These outcomes after combined treatment of primary tracheal cancer were significantly better compared to lung cancer (p<0.05 when compared to global data).

CONCLUSION

Treatment of primary tracheal cancer should be based on classical principles of modern oncology (combined therapy, tumor resection with lymphadenectomy). Open and endoscopic interventions are justified. PTC is characterized by more favorable outcomes compared to lung cancer. It is difficult to analyze long-term results in tracheal cancer depending on various features of tumor process due to small number of observations. Accurate conclusions require multiple-center studies, preferably with international participation, which can convincingly prove certain concept.

Keywords:

tracheal cancer
tracheal resection
malignant tracheal stenosis
tracheal cylindroma
tracheal carcinoid
tracheal cancer treatment outcomes
postoperative complications in tracheal cancer

Authors:

Parshin V.D.

Sechenov First Moscow State Medical University;
National Medical Research Center of Phthisiopulmonology and Infectious Diseases;
Federal Medical Biological Agency

Rusakov M.A.

Sechenov First Moscow State Medical University

Parshin A.V.

Sechenov First Moscow State Medical University

Mirzoyan O.S.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Simonova M.S.

Sechenov First Moscow State Medical University

Simonova M.S.

Sechenov First Moscow State Medical University

Parshin V.V.

Sechenov First Moscow State Medical University

Ursov M.A.

Sechenov First Moscow State Medical University

Received:

28.03.2022

Accepted:

06.04.2022

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