Late outcome after surgical management of carotid body tumors from a 20-year single-center experience

Drosos Kotelis, Timolaos Rizos, Philipp Geisbüsch, Nicolas Attigah, Peter Ringleb, Werner Hacke, Jens-Rainer Allenberg, Dittmar Böckler
Langenbeck's Archives of Surgery 2009, 394 (2): 339-44

BACKGROUND AND AIMS: Surgical resection is the treatment of choice for carotid body tumors. The aim of this study was to assess not only the perioperative, but also the long-term outcome after surgical treatment.

PATIENTS/METHODS: All patients that were operated on a carotid body tumor at our institution between 1986 and 2006 were reviewed. Data collection included patient profile, intraoperative findings and postoperative outcome.

RESULTS: Seventeen patients (11 female, six male) with 17 carotid body tumors (12 right, five left sided) were identified. Mean patient age at treatment was 49 years (range 19 to 76 years). Eight patients (47.1%) had large Shamblin type III tumors. Complete tumor resection was achieved in 16 of 17 cases (94.1%). Malignacy could not be proven in any patient. The 30-day mortality and stroke rates were 0. The incidence of temporary and permanent cranial nerve deficit was 41.2% and 11.8%, respectively. Patients with type III tumors had significantly higher risk of neurologic complications than patients with smaller tumors (p = 0.0152). The median postoperative follow-up was 6.4 years (range 1.5 to 20 years). The overall survival rate was 82.4%; the disease-specific survival rate was 94.1% (16 of 17 patients). One patient (5.6%) died of local tumor recurrence 3 years after a R1 resection. All the other patients showed no signs of local recurrence or metastases.

CONCLUSIONS: The surgical therapy of carotid body tumors shows low long-term morbidity, mortality, and recurrence rates. Cranial nerve injury is mostly temporary but a relevant procedure-related complication. Surgical resection is indicated also for small, asympomatic tumors, because of the uncomplicated resectability of these tumors.

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