Tracheal cancer: database analysis suggests resection is sufficient

  • Yusuf M & al.
  • Jpn J Clin Oncol
  • 12 Apr 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Adjuvant radiation therapy (RT) was not associated with OS benefits in patients with resected primary tracheal carcinoma.

Why this matters

  • Adjuvant RT has been used for patients at increased recurrence risk, but its potential benefits for these patients were poorly understood.

Key results

  • Patients with positive surgical margins (OR, 1.80; 95% CI, 1.06-3.07) and patients with adenoid cystic carcinoma (OR, 6.53; 95% CI, 3.57-11.95 vs squamous cell carcinoma) were more likely to receive adjuvant RT.
  • Adjuvant RT was not significantly associated with OS (HR, 1.23 [P=.1782] in multivariate Cox analysis; HR, 0.92 [P=.4969] in propensity score-weighted log-rank test).
  • Cancer grade 3/4 (HR, 2.45; P=.0031), surgical margins status (HR, 1.49 [P=.0295] for residual tumor; HR, 1.96 [P=.0002] for not evaluable/unknown), and regional/distant extension (HR 1.44; P=.0141) were associated with poor OS in multivariate analysis.
  • Adenoid (HR, 0.32; P<.0001 or other nonsquamous cell histology was associated with improved os in multivariate analysis.>

Study design

  • 549 patients with resected tracheal cancer, 55% who received RT, from the National Cancer Database (NCDB) were analyzed for survival outcomes.
  • Funding: Departmental funding.

Limitations

  • Retrospective study of large database.

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