Long-Term Outcomes of Patients With Carotid and Aortic Body Tumors

Abstract

Chemodectomas are tumors derived from parasympathetic nonchromaffin cells and are often found in the aortic and carotid bodies. They are generally benign but can cause mass-effect symptoms and have local or distant spread. Surgical excision has been the main curative treatment strategy. The National Cancer Database was reviewed to study all patients with carotid or aortic body tumors from 2004 to 2015. Demographic data, tumor characteristics, treatment strategies, and patient outcomes were examined, split by tumor location. Kaplan-Meier survival estimates were generated for both locations. In total, 248 patients were examined, with 151 having a tumor in the carotid body and 97 having a tumor in the aortic body. Many variables were similar between both tumor locations. However, aortic body tumors were larger than those in the carotid body (477.80±477.58mm vs 320.64±436.53mm, p=0.008). More regional lymph nodes were positive in aortic body tumors (65.52±45.73 vs 35.46±46.44, p<0.001). There were more distant metastases at the time of diagnosis in carotid body tumors (p=0.003). Chemotherapy was used more for aortic body tumors (p=0.001); surgery was used more for carotid body tumors (p<0.001). There are slight differences in tumor characteristics and response to treatment. Surgical resection is the cornerstone of management, and radiation can often be considered. In conclusion, chemodectomas are generally benign but can present with metastasis and compressive symptoms that make understanding their physiology and treatment important.