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Eur J Cardiothorac Surg 2001;19:339-345
© 2001 Elsevier Science NL

Tracheal cancer in Denmark: a nationwide study

^a Department of Clinical Physiology and Nuclear Medicine, Odense University Hospital, DK-5000 Odense, Denmark
^b Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
^c Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, OH, USA

Received 12 July 2000; received in revised form 11 November 2000; accepted 17 January 2001.

Corresponding author. Tel.: +45-65-412487
e-mail: peter.licht{at}ouh.dk

Objective: Most published series on tracheal cancer reflect single institution experiences. We used the nationwide Danish Cancer Registry to report on characteristics and treatment of tracheal cancers in Denmark. Methods: One hundred and nine cases of primary tracheal cancers were extracted from the registry in the period 1978–1995. The clinical data, histological distribution and treatment modalities were analyzed. The cancers were staged in four groups (stage I–IV) according to size, location and spread. Results: Seventeen cases were diagnosed at autopsy. Ninety-two cases were diagnosed in vivo and 84% of these within 3 months after the first consultation. Sixty-three percent of the cancers were squamous cell carcinomas and only 7% were adenoid cystic carcinomas. The disease was at stage I in 21%, stage II in 23%, stage III in 6% and stage IV in 50%. The majority of the patients received radiotherapy as single treatment. Only nine patients were offered surgery (six were resected and three were found inoperable). The overall survival rates for cases diagnosed in vivo were 1-year 32%, 2-year 20% and 5-year 13%. For the resected patients the 5- and 15-year survival rates were 50%. Conclusions: Tracheal cancers were rare and adenoid cystic carcinomas not as frequent as generally believed. Surgery was rarely offered. A resectability rate of only 10% is not adequately explained by selection bias and indicates a nihilistic attitude based on ignorance about surgical treatment of tracheal cancers. A more dedicated and aggressive approach with centralized workup and radical treatment is strongly recommended.

Key Words: Tracheal cancer • Cancer registry • Nationwide survey

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