Bronchoscopic intervention in the management of primary tracheobronchial adenoid cystic carcinoma with dyspnea

支气管镜介入治疗原发性气管支气管腺样囊性癌伴呼吸困难

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Abstract

BACKGROUND: Primary tracheobronchial adenoid cystic carcinoma (TACC) is a rare, slow-progressing malignant tumor whose airway obstruction frequently compromise survival. This study aimed to investigate the value of interventional bronchoscopy in TACC. METHODS: We retrospectively analyzed the clinical data of TACC patients treated between January 2006 and December 2024. 52 patients were stratified into two groups: the bronchoscopic intervention alone group (n = 25) and combined therapy group (n = 27). Kaplan-Meier methodology was employed to estimate median progression-free survival (PFS), overall survival (OS), and survival rates. Prognostic factors were further evaluated using Cox proportional hazards model. RESULTS: The mean age of 52 TACC patients was 51.77 ± 14.40 years. Bronchoscopic intervention demonstrated significant reduction in mMRC score and Freitag grade (P < 0.01). Median PFS and OS were 20 months and 118 months, respectively. The 3-/5-/10-year OS were 80.00%, 69.12%, and 34.87%. The combined therapy group exhibited superior PFS compared to the bronchoscopic intervention alone group (P < 0.05). Cox analysis identified combined therapy and stenosis degree as independent prognostic factors for PFS (P < 0.05). CONCLUSIONS: Bronchoscopic intervention demonstrated significant efficacy in alleviating dyspnea and airway stenosis while sustaining long-term survival in TACC patients. Multimodal therapy showed potential advantages in delaying disease progression.

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