Surgical outcomes and factors associated with malignancy in carotid body tumors

Wei Zhang; Fei Liu; Kai Hou; Xiaolong Shu; Bin Chen; Lixin Wang; Daqiao Guo; Weiguo Fu

doi:10.1016/j.jvs.2020.12.097

Surgical outcomes and factors associated with malignancy in carotid body tumors

J Vasc Surg. 2021 Aug;74(2):586-591. doi: 10.1016/j.jvs.2020.12.097. Epub 2021 Feb 4.

Authors

Wei Zhang¹, Fei Liu¹, Kai Hou², Xiaolong Shu¹, Bin Chen¹, Lixin Wang³, Daqiao Guo¹, Weiguo Fu⁴

Affiliations

¹ Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Vascular Surgery, Vascular Surgery Institute of Fudan University, Shanghai, China.
² Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
³ Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Vascular Surgery, Vascular Surgery Institute of Fudan University, Shanghai, China; Department of Vascular Surgery, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China. Electronic address: [email protected].
⁴ Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Vascular Surgery, Vascular Surgery Institute of Fudan University, Shanghai, China; Department of Vascular Surgery, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China.

PMID: 33548423
DOI: 10.1016/j.jvs.2020.12.097

Abstract

Objective: To compare the surgical outcomes of benign and malignant carotid body tumor (CBT), and to evaluate the associated factors of malignant CBT.

Methods: Patients who underwent surgical resection of CBT from 2005 to 2018 in a tertiary center were reviewed retrospectively. The common study follow-up end date was December 31, 2019. The tumor size was measured as the maximum transverse diameter on computed tomography scan. Surgical outcomes of benign and malignant CBT were compared. Associated factors of malignancy were analyzed by multivariate logistic analysis.

Results: There were 229 patients undergoing CBT resection. Sixteen patients were diagnosed with malignant CBT. The median follow-up time was 66 months (range, 6-142 months). Basic information including age, sex, course of disease, family history, lesion side, tumor size, and Shamblin classification showed no significant differences between the benign and malignant CBT groups. Patients with malignant CBTs showed a higher rate of preoperative symptoms (31.3% vs 12.2%; P < .05). The rates of vascular reconstruction or repair (P < .01) and neurologic complications (P < .05) were significantly higher in the malignant CBT group. In addition, a significantly longer average procedural time was required for malignant CBTs (P < .05). However, the estimated blood loss and length of hospital stay showed no significant difference. Multivariate logistic regression analysis revealed that the malignant odds of CBT with bilateral lesions (P = .0042; odds ratio, 8.30; 95% confidence interval, 1.84-35.88) or CBT with preoperative symptoms (P = .0016; odds ratio, 7.59; 95% confidence interval, 2.13-27.89) were high.

Conclusions: Compared with benign CBT, malignant CBT is prone to invasive clinical behaviors, resulting in an increased possibility of vascular reconstruction or repair during the surgery as well as postoperative neurologic complications. In addition, the malignant odds of CBT with bilateral lesions or CBT with preoperative symptoms are high.

Keywords: Carotid body tumor; Malignancy; Surgical outcomes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Blood Loss, Surgical
Carotid Body Tumor / diagnostic imaging
Carotid Body Tumor / pathology
Carotid Body Tumor / surgery*
Female
Humans
Length of Stay
Lymphatic Metastasis
Male
Middle Aged
Operative Time
Postoperative Complications / etiology
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Tumor Burden
Vascular Surgical Procedures* / adverse effects
Young Adult