Bronchoscopic intervention as a main treatment for tracheobronchial adenoid cystic carcinoma

Abstract Background: Bronchial adenoid cystic carcinoma (ACC) is a rare disease with low malignancy and indolent progression. Airway obstruction caused by ACC can be resolved by endoscopic procedures. The efficacy of different techniques of bronchoscopic interventions for ACC has not been determined. Material and Methods: From November 2004 to March 2012, ACC patients, mainly treated with different techniques of bronchoscopic interventions in our hospital, were reviewed. Results: The study included 37 ACC patients. Five patients (13.5%) with intra-luminal type underwent bronchoscopic therapies for a median of three times (range 1–6 times). Thirty-two patients (86.5%) with mixed type underwent bronchoscopic interventions for a median of 14 times (range 4–20 times). The dyspnea index was significantly improved after the first endoscopic procedure. The overall five- and ten-year survival rate was 85.9% and 45.9%, respectively, similar to surgery-dominant treatments. Conclusions: The present study demonstrates that different procedures of bronchoscopic interventions, as main treatments for ACC, are as effective as surgery-dominant treatment. More prospective and multicentric studies are required to confirm these favorable results, which may influence the therapeutic strategy for ACC in the future.

[1]  Hannes Kenngott,et al.  The past, present and future of minimally invasive therapy in urology: A review and speculative outlook , 2013, Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy.

[2]  K. Hsu,et al.  Endobronchial adenoid cystic carcinoma complicated with pneumothorax. , 2013, QJM : monthly journal of the Association of Physicians.

[3]  A. Çelik,et al.  Primary pulmonary adenoid cystic carcinoma: report of two cases , 2012, Asian cardiovascular & thoracic annals.

[4]  Wen Li,et al.  Adenoid cystic carcinoma of trachea: a case report and review of literature. , 2012, Chinese medical journal.

[5]  J. Cooper,et al.  Definitive radiotherapy for unresected adenoid cystic carcinoma of the trachea. , 2012, Chest.

[6]  Chang Chen,et al.  Radical mediastinal nodal removal improves disease-free survival for pulmonary low-grade malignant tumors. , 2012, Lung cancer.

[7]  D. Elashoff,et al.  Adenoid Cystic Carcinoma of the Airway: 30‐Year Review at One Institution , 2012, American journal of otolaryngology.

[8]  Takashi Suzuki What is the best management strategy for adenoid cystic carcinoma of the trachea? , 2011, Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia.

[9]  Y. Shim,et al.  Treatment outcomes of patients with adenoid cystic carcinoma of the airway. , 2011, Lung cancer.

[10]  Y. Shim,et al.  Primary salivary gland-type lung cancer: surgical outcomes. , 2011, Lung cancer.

[11]  E. Mark,et al.  Prognostic value of pathologic characteristics and resection margins in tracheal adenoid cystic carcinoma. , 2010, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[12]  Y. Ichinose,et al.  A long-term survivor after aggressive treatment for tracheal adenoid cystic carcinoma: a case report. , 2007, Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia.

[13]  W. Mendenhall,et al.  Surgery and postoperative radiotherapy for adenoid cystic carcinoma of the lung. , 2006, American journal of clinical oncology.

[14]  M. Gokhale,et al.  Uncommon primary tracheal tumors. , 2006, The Annals of thoracic surgery.

[15]  Maw-Sen Liu,et al.  Adenoid cystic carcinoma of the trachea: a report of seven cases and literature review. , 2005, Chang Gung medical journal.

[16]  A. Vigg,et al.  Adenoid cystic carcinoma of trachea. , 2004, The Indian journal of chest diseases & allied sciences.

[17]  Y. Ichinose,et al.  Treatment outcome of resected and nonresected primary adenoid cystic carcinoma of the lung. , 2002, Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia.

[18]  A. Mehta,et al.  Successful management of adenoid cystic carcinoma of the trachea by laser and irradiation. , 1999, Chest.

[19]  S. Keshavjee,et al.  Adenoid cystic carcinoma of the airway: thirty-two-year experience. , 1996, The Journal of thoracic and cardiovascular surgery.

[20]  C. Torikata,et al.  Adenoid cystic carcinoma of the trachea and main-stem bronchus. A clinical, histopathologic, and immunohistochemical study. , 1988, The Journal of thoracic and cardiovascular surgery.

[21]  I. Takata,et al.  Primary adenoid cystic carcinoma of the trachea effectively treated with the endoscopic Nd-YAG laser followed by radiation. , 1996, Internal medicine.