Tracheal cancers

Primary tracheal tumors are very rare and the literature on this subject is limited. Due to their rarity and diversity, the provision of patient care in terms of optimal management poses a considerable challenge. There are no unequivocal guidelines concerning the treatment in patients with local or distant disease. The most common types of primary tracheal tumors are squamous cell carcinoma and adenoid cystic carcinoma. Squamous cell carcinoma of the trachea is 2-4 times more common in men than in women and develops primarily in the sixth and seventh decades of life. It is strongly associated with tobacco smoking. Adenoid cystic carcinoma of the trachea occurs with similar frequency in men and women, and is most common in the fourth and fifth decades of life. The etiol- ogy of this type is unknown, however it is not associated with tobacco smoking. Adenoid cystic carcinoma is characterized by submucosal and perineural spread. Treatment of patients with primary tracheal tumors requires a multidisciplinary approach. Optimal treatment of localized tumors is based on surgery or radiotherapy. If distant metastases are present the therapeutic palliative methods are: chemotherapy, palliative radiotherapy or palliative surgery. The prognosis of patients with primary tracheal tumors is determined by several factors. Histological diagnosis of adenoid cystic carcinoma, good performance status, and complete resection have been identified as favorable prognostic factors. Despite intensive treatment, the 5 -year survival rate for primary tracheal tumors is not satisfactory.