Management of the thyroid gland during laryngectomy

• Published in: Journal of laryngology and otology 2017-08, Vol.131 (8), p.740-744
• Main Authors: Li, S X, Polacco, M A, Gosselin, B J, Harrington, L X, Titus, A J, Paydarfar, J A
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Cancer therapies; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Cartilage; Cartilage - pathology; Cartilage - surgery; Dissection; Female; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - surgery; Humans; Hypopharyngeal Neoplasms - pathology; Hypopharyngeal Neoplasms - surgery; Hypopharynx; Hypothyroidism; Incidence; Laryngeal cancer; Laryngeal carcinoma; Laryngeal Neoplasms - pathology; Laryngeal Neoplasms - surgery; Laryngectomy - methods; Larynx; Main Articles; Male; Metastases; Middle Aged; Neck; Neoplasm Invasiveness; Patients; Predictive Value of Tests; Radiation therapy; Retrospective Studies; Squamous cell carcinoma; Squamous Cell Carcinoma of Head and Neck; Thyroid; Thyroid gland; Thyroid Gland - pathology; Thyroid Gland - surgery; Thyroid Neoplasms - epidemiology; Thyroid Neoplasms - secondary; Thyroid Neoplasms - surgery; Thyroidectomy; Thyroidectomy - methods; Thyroidectomy - statistics & numerical data; Tomography; Tongue; Treatment Outcome; Tumors
• ISSN: 0022-2151; 1748-5460
• DOI: 10.1017/S0022215117001244

This study aimed to: describe the incidence of thyroid gland involvement in advanced laryngeal cancer, analyse patterns of spread to the thyroid and elucidate predictors of thyroid involvement. A retrospective review was performed on patients who underwent laryngectomy from 1991 to 2015 as a primary or salvage treatment for squamous cell carcinoma of the larynx, hypopharynx or base of tongue. The incidence of thyroidectomy during total laryngectomy, type of thyroidectomy, incidence of gland involvement, route of spread, and positive predictors of spread were analysed and reported. A total of 188 patients fit the inclusion criteria. Of these, 125 (66 per cent) underwent thyroidectomy. The thyroid was involved in 10 of the 125 patients (8 per cent), 9 by direct extension and 1 by metastasis. Cartilage invasion was a predictor of thyroid gland involvement, with a positive predictive value of 26 per cent. There is a low incidence of thyroid gland involvement in laryngeal carcinoma. Most cases of gland involvement occurred by direct extension. Thyroidectomy during laryngectomy should be considered for advanced stage tumours with cartilage invasion.