Carotid body tumor contemporary management in a high-volume centre.

BACKGROUND The aim of this study is to report our results with carotid body tumour (CBT) surgical management. METHODS Between 2010 and 2018, 100 CBTs (mean age: 48.0 years, range 21-80 years old) were treated in our centre. The patients were classified in 3 groups according to the size: group I (< 3cm), 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 tumour size is to be considered a risk factor for CNI because large CBTs remain at high risk for CNIs.