Primary tracheal cancer: Demographics, histology, and treatment outcomes in the United States from 2000-2018.

Abstract

e18060 Background: Primary tracheal cancers (PTC) account for 0.2% of all respiratory malignancies and have an estimated incidence of 2.6 new cases per one million people in the US. Given the rarity of these cancers and paucity of data in the literature, we sought to determine the demographic and treatment patterns of PTC in the US. Methods: A retrospective cohort study utilizing the Surveillance, Epidemiology, and End Results (SEER) database sponsored by the National Cancer Institute (NCI) was conducted for patients with a diagnosis of PTC between 2000 and 2018. Univariate, multivariate, and survival analyses were performed using 95% confidence intervals [CI] and a p-value < 0.05 indicating significance. Results: 689 patients with PTC were identified, with 53% of these cases being squamous cell carcinoma (SCC) and 17% being adenoid cystic carcinoma (ACC). Comparison of five-year overall survival (OS) stratified by treatment modality, disease stage, and histology can be found in the table. Multi-factor analysis demonstrated significance with only disease histology (p=0.005). Asian patients with SCC had decreased five-year OS compared to White or Black patients (n=12; hazard ratio (HR)=0.19 and 0.20, and p=0.003 and 0.006, respectively). Patient age < 65 years was associated with increased survival (hazard ratio (HR)=0.48; p<0.001); no difference in survival based on sex or marital status was seen (sex: HR=1.03; p=0.733, marital status: HR=1.07; p=0.568). Conclusions: Patients with tracheal ACC had greater five-year OS compared to patients with tracheal SCC. Those with local or regional SCC that received surgery or RT saw survival benefit; patients with regional SCC had survival benefit with chemotherapy. Patients with ACC had no survival benefit from any treatment modality regardless of stage. Patients aged < 65 years had increased survival and Asian patients with SCC had decreased survival. Further investigation into the potential differences in survival among various chemotherapeutic regimens and socioeconomic factors is warranted.[Table: see text]