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Adapted from Gaissert HA et al.6

Nearly all received postoperative irradiation of varied dosage. Margins are at proximal and distal resection lines. Lateral margins and lymph nodes are not noted here.

figure 7-22 Survival of patients resected for adenoid cystic carcinoma (ACC) and squamous cell carcinoma (SCC) with negative and positive margins. Margins are proximal and distal lines of resection.

patients, 165 underwent tracheal resection and primary anastomosis, 24 underwent carinal resection, and 19 underwent laryngotracheal resection, with an overall mortality of 10.5%. Survival at 5 and 10 years for ACC was 73% and 57%, and 47% and 36% for other tracheal cancers (squamous plus 4 with adenocarcinoma), respectively. Comparative observations on treatment of ACC by several groups are summarized in Table 7-13. The behavior of our remaining heterogeneous group of 48 tumors other than squamous cell or adenoid cystic carcinomas may be summarized as follows.1 Typical carcinoids did not recur, mucoepidermoid tumors behaved benignly in this series, and all benign tumors were cured. The few aggressive sarcomas generally suffered early recurrence. On the other hand, malignant fibrous histiocytoma, pseudosarcoma, and low-grade spindle cell sarcoma did not recur. Two small cell carcinomas, which had no evidence of nodal spread and were treated with additional standard chemotherapy, showed no recurrence in over 5 years. Unfortunately, these experiences are in anecdotal numbers only.

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