Kevin Tsai Primary malignant tumors of the trachea are rare1
Etiology:
Erin Primary malignant tumors of the trachea are very uncommon, and usually metastasize to the trachea from another area.1 The most common cause is directly related to smoking.
Signs & Symptoms:
Spencer The following are the most common signs and symptoms of Tracheal cancer.1
Hemoptysis
Dyspnea
Hoarseness
Cough
Recurrent Pneumonia
Vocal Cord Palsy
Diagnostic Procedures:
Pablo Diagnostic procedures for cancer of the trachea include:
Complete medical history
Blood test
X-rays
Computerized tomography (CT)
Magnetic resonance imaging (MRI)
Bronchoscopy¹
Histology:
Becky
Malignant tumors of the trachea include:
Adenocarcinoma
Squamous cell carcinoma
Adenosquamous carcinoma
Adenoid cystic carcinoma
Mucoepidermoid carcinoma
Neuroendocrine carcinoma
Most common is squamous cell carcinoma and adenoid cystic carcinoma.1
Lymph node drainage:
Adam The adjacent lymph nodes to the trachea are the first to become involved when the cancer spreads, which can ultimately lead to metastasis to distant organs down the line. The tracheal nodes drain to the bronchomediastinal lymph trunks.1
Metastatic spread:
Megan Determined at the first doctor’s appointment, approximately 1/3 of patients with tracheal cancer have mediastinal spread or pulmonary metastases.1 At first the tumor will involve neighboring lymph nodes and any mediastinal structures via direct extension.1 Metastasis to distant organs such as the lungs, liver, and bone are common.1 Also, when dealing with the histology of adenoid cystic carcinoma, extension beyond the trachea is 3 times more common than with the histology of squamous cell carcinoma.1
Grading:
Kevin Tsai
Low grade - cancer cells look similar to normal cells and grow more slowly which is less likely to spread
High grade - cells look more abnormal and are more likely to spread.2
Staging:
Erin No staging system exists for primary tracheal tumors1
Radiation side effects:
Spencer Some of the most common side effects of radiation therapy to the trachea include.1
Acute Odynophagia/Dysphagia
Cough
Local irritation
Late effects include softening of the cartilage, tracheitis, and tracheal stenosis
Esophageal stricture
Esophageal fistulas and vocal cord paralysis
Prognosis:
Pablo Prognosis Survival for patients affected with cancer of the trachea is highly dependent on the type of tumor, how advanced the disease is at the time of diagnosis and the overall health of the patient. For adenoid cystic carcinoma the mean survival range is 78% for 5 years. For squamous cell carcinoma the 5 year survival is only 34%. If the patient undergoes total resection of the tumor, the prognosis is much better, 5 and 10 year survival rates are between 90% and 95%.²
Treatments:
Becky
Treatment of choice is primarily surgery. Postoperative irradiation is generally recommended. If a patient is unable to undergo surgery, then external-beam irradiation and/or endotracheal brachytherapy are recommended. Chemotherapy alone is not generally useful and is recommended in conjunction with other modalities.1
TD 5/5:
Adam There isn't a specific TD5/5 for the trachea itself, so when treating tracheal cancers, it's important to focus on the surrounding structures such as the lungs (3000cGy), spinal cord (4500cGy), heart (4500 cGy), esophagus (6000cGy), etc.2
References:
Chao C, Perez C, Brady L. Radiation Oncology Management Decisions. 3rd ed. PA: Lippincott Williams and Wilkins; 2011:341-350.
Primary malignant tumors of the trachea are rare1
Primary malignant tumors of the trachea are very uncommon, and usually metastasize to the trachea from another area.1 The most common cause is directly related to smoking.
The following are the most common signs and symptoms of Tracheal cancer.1
Diagnostic procedures for cancer of the trachea include:
Malignant tumors of the trachea include:
- Adenocarcinoma
- Squamous cell carcinoma
- Adenosquamous carcinoma
- Adenoid cystic carcinoma
- Mucoepidermoid carcinoma
- Neuroendocrine carcinoma
Most common is squamous cell carcinoma and adenoid cystic carcinoma.1The adjacent lymph nodes to the trachea are the first to become involved when the cancer spreads, which can ultimately lead to metastasis to distant organs down the line. The tracheal nodes drain to the bronchomediastinal lymph trunks.1
Determined at the first doctor’s appointment, approximately 1/3 of patients with tracheal cancer have mediastinal spread or pulmonary metastases.1 At first the tumor will involve neighboring lymph nodes and any mediastinal structures via direct extension.1 Metastasis to distant organs such as the lungs, liver, and bone are common.1 Also, when dealing with the histology of adenoid cystic carcinoma, extension beyond the trachea is 3 times more common than with the histology of squamous cell carcinoma.1
No staging system exists for primary tracheal tumors1
Some of the most common side effects of radiation therapy to the trachea include.1
Prognosis
Survival for patients affected with cancer of the trachea is highly dependent on the type of tumor, how advanced the disease is at the time of diagnosis and the overall health of the patient. For adenoid cystic carcinoma the mean survival range is 78% for 5 years. For squamous cell carcinoma the 5 year survival is only 34%. If the patient undergoes total resection of the tumor, the prognosis is much better, 5 and 10 year survival rates are between 90% and 95%.²
Treatment of choice is primarily surgery. Postoperative irradiation is generally recommended. If a patient is unable to undergo surgery, then external-beam irradiation and/or endotracheal brachytherapy are recommended. Chemotherapy alone is not generally useful and is recommended in conjunction with other modalities.1
There isn't a specific TD5/5 for the trachea itself, so when treating tracheal cancers, it's important to focus on the surrounding structures such as the lungs (3000cGy), spinal cord (4500cGy), heart (4500 cGy), esophagus (6000cGy), etc.2