# Surgical Outcomes of Central Airway Adenoid Cystic Carcinoma: A Retrospective Single-Center Analysis

## TL;DR

This study examines surgical outcomes for a rare airway cancer, finding that surgery with reconstruction and adjuvant therapy can provide long-term control despite risks.

## Contribution

The study provides a single-center analysis of surgical outcomes for central airway adenoid cystic carcinoma, a rare malignancy with no standard treatment.

## Key findings

- Eight patients underwent surgical resection with various airway reconstruction techniques.
- The 5-year overall survival rate was 72.9%, with two patients experiencing recurrence.
- Major complications included recurrent laryngeal nerve palsy and one fatal tracheoinnominate artery fistula.

## Abstract

Central airway adenoid cystic carcinoma (CAACC) is a rare malignancy lacking a standard treatment approach and often precluding complete resection. This study assessed the surgical outcomes of patients with CAACC treated at a single institution.

We retrospectively reviewed patients who underwent surgical resection for CAACC between September 2013 and August 2021.

Eight patients (mean age: 51.5 years) were included. Tumor locations were bronchus (n = 1), trachea (n = 4), carina and bronchus (n = 2), and carina and trachea (n = 1). Surgical procedures included sleeve lobectomy (n = 1), tracheal resection (n = 4), sleeve pneumonectomy (n = 2), and carinal resection with reconstruction (n = 1). Preoperative radiation and bronchoscopic tumor resection were performed in 1 patient each. One patient died from a postoperative tracheoinnominate artery fistula. Major complications included recurrent laryngeal nerve palsy (n = 3). Adjuvant therapy was provided for positive or uncertain margins. During a median follow-up of 6 years, 2 patients developed recurrence but remained alive at the last follow-up. The 5-year overall survival rate was 72.9%.

Surgical resection with airway reconstruction and adjuvant therapy can offer long-term disease control in CAACC, though life-threatening complications warrant careful consideration.