Carotid body tumor contemporary management in a high-volume center

J Cardiovasc Surg (Torino). 2020 Aug;61(4):459-466. doi: 10.23736/S0021-9509.19.10496-X. Epub 2019 Oct 4.

Abstract

Background: The aim of this study is to report our results with carotid body tumor (CBT) surgical management.

Methods: Between 2010 and 2018, 100 CBTs (mean age: 48.0 years, range 21-80 years old) were treated in our center. The patients were classified in 3 groups according to the size: group I (<3 cm), group II (3 to 5 cm) and group III (>5 cm).

Results: Surgical resection was performed in 88 patients and conservative treatment in 2 cases. Nine patients were treated for bilateral involvement and one of them was also treated again for a relapse. Postoperatively, cranial nerve injury (CNI) was significantly higher in group II [3 (8.3%) vs. 16 (31.4%) vs. 2 (15.4%); P=0.030] with no statistical differences between the CN involved. At univariate analysis for CNI, CBT group (P=0.030), maximum diameter (P=0.046), patients presenting with dysphonia (P=0.035) and dysphagia (P=0.007) and patients suffering from any intraoperative complication (P=0.047) were statistically significant. At multivariate analysis the only significant variable was CBT group II (P=0.016). For blood loss, CBT group III (P<0.001), Shamblin class III (P<0.001), Pulmonary disease (P=0.034) and surgery time (P<0.001) were statistically significant. The follow-up of 79 patients (87.8%) showed a 100% overall survival at median follow-up of 37.7 months (range 2-84.7 months) with freedom from local recurrence of 97.8% (77/79).

Conclusions: Surgical resection remains the gold standard to obtain complete recovery, although tumor size is to be considered a risk factor for CNI because large CBTs remain at high risk for CNIs.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography
  • Carotid Body Tumor / mortality
  • Carotid Body Tumor / surgery*
  • Carotid Body Tumor / therapy
  • Conservative Treatment
  • Contrast Media
  • Embolization, Therapeutic
  • Female
  • Humans
  • Iopamidol
  • Male
  • Middle Aged
  • Operative Time
  • Radiotherapy
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Vascular Surgical Procedures

Substances

  • Contrast Media
  • Iopamidol