Crico-tracheal resection and anastomosis for primary and secondary tumours of the laryngo-tracheal junction: a single centre series of 78 patients

Objective: The aim of this study is to analyse data related to (crico-)tracheal resection and anastomosis [(C)TRA] for primary or secondary tumours involving the laryngo-tracheal junction, focusing on clinical indications, oncological, and functional outcomes. Methods: A retrospective analysis was conducted on patients treated by (C)TRA from September 1996 to October 2025 in a single academic tertiary referral centre. Patients were distinguished into 5 subgroups based on tumour histology as: 1) advanced thyroid carcinomas involving the airway, 2) cricoid and tracheal chondrosarcomas, 3) minor salivary gland tumours, 4) squamous cell carcinomas, and 5) other rarer histotypes. Primary endpoints included overall (OS), disease-specific (DSS), and laryngectomy-free survivals (LFS). Results: The cohort consists of 78 patients submitted to 80 (C)TRA distributed among Types A, B, C, and E. The most frequent histotypes were advanced thyroid carcinomas and chondrosarcomas. The final decannulation rate was 97.4% with an overall complication rate of 27.5%. Five-year OS, DSS, and LFS were 65.4, 76.7, and 95%, respectively. Conclusions: (C)TRA represents an effective surgical strategy for tumours involving the laryngo-tracheal junction, preserving laryngeal functions without compromising oncologic prognosis. Outcomes are excellent for well-differentiated thyroid or cartilaginous tumours, while caution is warranted in high-grade histologies, extrinsic infiltration from metastatic lymph nodes, or previously irradiated patients.