Bronchoscopy, surgery and radiation therapy for bronchial adenoid cystic carcinoma: A retrospective cohort study.

Background: Adenoid cystic carcinoma (ACC) of the bronchus is a rare malignancy, accounting for 1-2% of all respiratory tumors. Its slow growth often results in delayed diagnosis. Although surgical resection is the preferred treatment, ACC frequently demonstrates local invasiveness, leading to central airway obstruction that worsens respiratory symptoms and adversely affects prognosis. Consequently, bronchoscopic interventions and radiation therapy are often required for disease management. Objective: To evaluate the long-term outcomes of multimodal management, including surgery, radiation therapy, and bronchoscopic interventions, in patients with bronchial ACC treated at our institution. Methods: We conducted a retrospective review of medical records for patients diagnosed with bronchial ACC at our institution between April 1, 2005, and December 31, 2024. Clinical data, including patient demographics, treatment modalities, and overall survival (OS), were collected and analyzed. Results: Eleven patients with central airway lesions were included. The mean age at diagnosis was 61±15 years, and the median OS was 73.4 months (range: 1-158 months). Bronchoscopic interventions under general anesthesia, including argon plasma coagulation, high-frequency snaring, and airway stenting, were performed in nine patients. Seven patients underwent surgical resection, including six tracheal anastomoses and one left total pneumonectomy. Postoperative radiation therapy was administered to seven patients. Conclusion: A multimodal approach incorporating bronchoscopy, surgery, and radiation therapy may improve outcomes in patients with bronchial ACC.