Past
Primary tracheal cancers (PTCs) are rare neoplasms, with an estimated incidence of just one per one million individuals.1 Current literature recommends surgical management of these cancers, though there is a dearth of literature on general outcomes and a relative undertreatment of PTC with surgery has been reported.2 Even less literature exists exploring the role of other oncologic treatment modalities and the role of multimodal therapy, and currently no consensus guidelines exist for the management of these cancers.
Present
We performed a population-level analysis of patients with PTC identified via the Surveillance, Epidemiology, and End Results (SEER) database to assess for factors associated with increased 5-year cause-specific survival (CSS).3 On multivariate analysis, patient age < 65 years at diagnosis (hazard ratio (HR) = 0.64, p < 0.001), non-squamous cell carcinoma (SCC) histologies (namely, adenoid cystic carcinoma (ACC); HR = 0.22, p < 0.001), and treatment with surgery (HR = 0.43, p < 0.001) were all associated with increased CSS. Despite these findings, 55% of the entire cohort (n = 380) did not receive surgical treatment, with most of these patients having SCC histology (58%).
Future
These results suggest that significant differences in outcomes with respect to patient age and PTC histology exist among the US population. Furthermore, while surgery was found to improve survival among patients with PTC, a relative undertreatment trend continues to exist, especially among those with SCC of the trachea. More research is needed to assess these trends and to serve as the basis for future evidence-based guideline creation.
Funding
Open access funding provided by the Carolinas Consortium.
Disclaimer
The views and opinions expressed in this article/presentation are those of the author and do not necessarily reflect official policy or position of the United States Air Force, Defense Health Agency, Department of Defense, or U.S. Government.
Footnotes
This article refers to: Armel K, Stamey T, Maitre J, et al. Demographic, disease, and treatment characteristics of primary tracheal cancers. Ann Surg Oncol. (2024). 10.1245/s10434-024-16520-1.
The original online version of this article was revised: US Government disclaimer was added.
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Change history
8/18/2025
A Correction to this paper has been published: 10.1245/s10434-025-18193-w
References
- 1.Kazzaz F, O’Connell O, Vial MR, Grosu HB. Primary tracheal carcinoma. J Bronchol Interv Pulmonol. 2018;25(4):330. 10.1097/LBR.0000000000000494. [DOI] [PubMed] [Google Scholar]
- 2.Honings J, Gaissert HA, Verhagen AFTM, et al. Undertreatment of tracheal carcinoma: multidisciplinary audit of epidemiologic data. Ann Surg Oncol. 2009;16(2):246–53. 10.1245/s10434-008-0241-3. [DOI] [PubMed] [Google Scholar]
- 3.Armel K, Stamey T, Maitre J, et al. Demographic, disease, and treatment characteristics of primary tracheal cancers. Ann Surg Oncol. 2024. 10.1245/s10434-024-16520-1. [DOI] [PMC free article] [PubMed] [Google Scholar]