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Surgical Evolution and Long-Term Control in Carotid Body Tumors. An Institutional Experience over Two Decades
Claudio Vincenzoni1, Teresa Lodico1, Lucia Pia Mangiacotti1
1Unit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Unit of Vascular Surgery, Department of Cardiovascular Sciences, Università Cattolica del Sacro Cuore, Rome, Italy.
This study on carotid body tumors (CBTs) shows that open surgical resection with selective embolization and vascular reconstruction leads to low permanent neurologic morbidity and durable oncologic outcomes. Our 22-year experience refined management strategies for these rare neoplasms.
Area of Science:
- Vascular Surgery
- Surgical Oncology
- Head and Neck Neoplasms
Background:
- Carotid body tumors (CBTs) are rare neoplasms lacking standardized diagnostic and management guidelines.
- This study evaluates a 22-year single-center experience to refine treatment strategies for CBTs.
- An institutional care bundle was developed based on this longitudinal experience.
Purpose of the Study:
- To longitudinally evaluate operative strategy, perioperative risk mitigation, and long-term outcomes for carotid body tumors.
- To describe an institutional care bundle derived from extensive single-center experience.
- To assess the impact of temporal changes in techniques on patient outcomes.
Main Methods:
- Retrospective cohort study with prospective follow-up of 74 patients (81 tumors) undergoing open resection for CBT.
- Data extracted included demographics, imaging, operative details, histopathology, and follow-up.
- Tumors staged by Shamblin classification; primary endpoint was perioperative morbidity, mortality, recurrence, and oncologic status.
Main Results:
- 81 procedures performed: 77 complete resections, 2 partial resections, 2 embolizations alone.
- Early postoperative complications occurred in 18.9% (dysphagia, dysphonia, wound hematoma, Horner syndrome, aspiration pneumonia).
- No perioperative or follow-up deaths; one local recurrence managed conservatively; no metastatic disease identified.
Conclusions:
- Temporal changes in imaging, embolization, and dissection techniques are associated with improved outcomes.
- Open surgical resection with selective preoperative embolization and vascular reconstruction yields low permanent neurologic morbidity.
- This approach is associated with durable oncologic outcomes in a high-volume tertiary practice.