Endoscopic Resection for Tracheal Adenoid Cystic Carcinoma? Is It Time to Change How We Practice?

The central dogma of R0 resection and adjuvant radiation for management of tracheal adenoid cystic carcinoma (ACC) was recently challenged in a publication by Yang and colleagues.1 This study demonstrated how long-term survival of tracheal ACC patients did not change despite R0 resection, and adjuvant radiation did not affect the 5-year or 10-year survival rate of patients. Contrary to other recent literature,2 this study demonstrated that patients with macroscopic positive margins (R2) had no significant difference in terms of 5-year or 10-year survival, suggesting that leaving gross tumor behind does not have an impact on patient outcome.