BACKGROUND.: Primary salivary‐type lung cancers are rare tumors that include adenoid cystic carcinoma (ACC) and mucoepidermoid carcinoma (MEC). The clinicopathologic profiles, symptoms on presentation, and long‐term outcomes of patients with ACC and MEC as an overall group have not been defined recently.METHODS.: In this study, the authors analyzed clinical outcome data from 62 patients who presented with a diagnosis of primary salivary‐type lung cancer at the Mayo Clinic (Rochester, Minn) from 1972 to 2002.RESULTS.: The median age at diagnosis for patients with MEC was 40 years (range, 6–78 years); and, for patients ACC, the median age at diagnosis was 54 years (range, 21–76 years). ACC was observed more frequently among women and girls. The main presenting symptom for both tumors was cough (70%), followed by dyspnea (51.7%), wheezing (38.3%), obstructive pneumonia (30%), hemoptysis (28.3%), and fever (16.7%). Tissues were available for review from all patients. Among the ACC tumors, 29 (74.4%) were cribriform, 7 (17.9%) were tubular, and 3 (7.7%) were the solid type. Most MEC tumors (65%) were intermediate grade (grade 2), and 30% were low grade (grade 1). Most salivary‐type lung cancers presented in the trachea, in the carina, or in a main stem bronchus (70.7%). This location was observed more often (82.5%) for ACC tumors compared with MEC tumors (44.4%). Involvement of the lymph nodes was observed in 20% of patients and was more common among the patients with ACC (30.8%). Distant metastases were observed in 30.4% of the patients (15 patients in the ACC group [40.5%] compared with only 2 patients in the MEC group [10.5%]; P = .03). For patients who underwent complete surgical resection, the 3‐, 5‐, and 10‐year survival rates were 82%, 70%, and 63%, respectively. The survival rates for surgical MEC patients were 94% at 3 years and 87% at both 5 years and 10 years. For surgical ACC patients, the survival rates were 73%, 57%, and 45% at 3, 5, and 10 years, respectively. The survival rate for patients with ACC who did not undergo surgery was 74% at 3 years, 53% at 5 years, and 31% at 10 years. The difference in survival between surgical and nonsurgical patients was statistically significant (P < .01).CONCLUSIONS.: Patients with MEC and ACC frequently have a good long‐term prognosis but do not always have indolent diseases. Local recurrence is likely if complete surgical resection is not achieved. ACC has a higher likelihood than MEC to metastasize. Overall, patients with MEC survive better than patients with ACC. Cancer 2007. © 2007 American Cancer Society.

BACKGROUND.: Outcome results of a long‐term analysis of urachal cancer using a new staging system are presented.METHODS.: The authors analyzed clinical outcomes from 49 patients with the diagnosis of urachal cancer who were seen at the Mayo Clinic, Rochester, Minnesota from 1950 to 2003. The TNM staging system was used to predict outcome after surgical resection.RESULTS.: Among 49 study patients, 33 were men, 16 were women, and their median age at presentation was 57.5 years. The vast majority of tumors were adenocarcinomas (89%), 4% were sarcomas and transitional cell carcinomas, and the rest were high‐grade mixed neoplasms. Among the adenocarcinomas, 63.6% were mucin‐producing tumors. Partial cystectomy with or without pelvic lymph node dissection and removal of the urachus was performed in 41 (83%) cases. Overall survival for all stages was 62 months with 17 (34%) patients still alive more than 5 years after treatment. Applying the TNM staging system, the authors demonstrated a median survival time for stage I/II patients of 10.8 years (95% CI, 6.9 years to 12.0 years) compared with a median survival of 1.3 years (95% CI, 1.1 years to 1.9 years; log‐rank P<.0001) for patients with advanced disease (stages III and IV).CONCLUSIONS.: Stage at presentation by the TNM staging system proved to be the main predictor of outcome after surgery for urachal cancer. Better systemic modality treatments are needed for advanced stages of this disease. Cancer 2007. © 2007 American Cancer Society.