Tracheobronchial adenoid cystic carcinoma: a two-center retrospective analysis of clinical features and survival outcomes.

BACKGROUND: Tracheobronchial adenoid cystic carcinoma (TACC) is an uncommon gland-type tumor. While prior studies have addressed its clinical features and prognosis, evidence from larger cohorts remains scarce. METHODS: TACC patients treated at Dongzhimen Hospital (DZM) and Emergency General Hospital (EG) between 2010 and 2023 were enrolled. Survival curves were plotted using the Kaplan-Meier method before and after propensity score matching (PSM). The key variables were screened by LASSO regression, and predictive and interaction analysis was done by multifactor Cox regression and accelerated failure time (AFT) models. Overall survival (OS) was the study endpoint. RESULTS: The median age of 169 TACC patients (EG 144, DZM 25) was 47.8 ± 13.2 years, 50.9% were female, and 79.9% of patients had not undergone surgery. The median follow-up was 67.5 months (interquartile range [IQR] 42.2-105.8). Survival at 5, 10, and 15 years was 68.0%, 32.4%, and 17.1%, respectively. The median survival time was 88 months. Multifactorial Cox regression analysis found initial tumor extension (ITE) (HR: 1.28, 95% CI 1.12-1.47; P = 0.000), surgery (HR: 0.36, 95% CI 0.20-0.64; P = 0.000), and photodynamic therapy (PDT) (HR: 0.46, 95% CI 0.22-0.97; P = 0.042) to be independent prognostic factors; this was re-affirmed by AFT model. Survival was extended by surgery combined with PDT, but the interaction was nonsignificant. CONCLUSION: This study identified ITE as the independent prognostic factor. Surgery is the key to the prognosis, and PDT and its combination with surgery may enhance patient survival.