Surgical management of thyroid cancer invading the airway
Locally advanced thyroid cancer invading the tracheal cartilage represents a difficult treatment dilemma during thyroidectomy. A retrospective chart review was performed to determine the results of laryngotracheal resection or tracheal cartilage shave with adjuvant radiotherapy in patients with loca...
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Veröffentlicht in: | Annals of surgical oncology 1997-07, Vol.4 (5), p.403-408 |
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creator | McCarty, T M Kuhn, J A Williams, Jr, W L Ellenhorn, J D O'Brien, J C Preskitt, J T Lieberman, Z H Stephens, J Odom-Maryon, T Clarke, K G Wagman, L D |
description | Locally advanced thyroid cancer invading the tracheal cartilage represents a difficult treatment dilemma during thyroidectomy.
A retrospective chart review was performed to determine the results of laryngotracheal resection or tracheal cartilage shave with adjuvant radiotherapy in patients with locally advanced thyroid cancer invading the upper airway.
Of 597 patients undergoing thyroidectomy for thyroid cancer, 40 were found to have laryngotracheal invasion. Thirty-five patients with superficial invasion underwent cartilage shave procedures with adjuvant radiotherapy; five with full-thickness invasion underwent radical resection, including tracheal sleeve resection (n = 3) or total laryngectomy (n = 2). Histologic subtypes included papillary (n = 32), follicular (n = 2), Hurthle cell (n = 1), medullary (n = 3), and anaplastic (n = 2). Of the cartilage shave group, 25 are currently alive with no evidence of disease at a mean follow-up of 81 months (range 1-290). Six developed isolated local/regional recurrence and were managed with total laryngectomy (n = 1), tracheal resection (n = 1), cervical lymphadenectomy (n = 1), or repeat radiotherapy (n = 3). All six patients remain free of disease at a mean follow-up of 5 years. Of those who underwent initial laryngotracheal resection, four remain free of disease at a mean follow-up of 5 years. The rates of 10-year disease-free survival and overall survival for all patients were 47.9% (95% confidence interval [CI] 24.8, 71.0) and 83.9% (95% CI 70.3, 97.5), respectively.
These data suggest that adequate management of thyroid cancer with laryngotracheal invasion can be achieved with a more conservative surgical approach and adjuvant radiotherapy, reserving more radical resections for extensive primary lesions or locally recurrent disease. |
doi_str_mv | 10.1007/bf02305553 |
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A retrospective chart review was performed to determine the results of laryngotracheal resection or tracheal cartilage shave with adjuvant radiotherapy in patients with locally advanced thyroid cancer invading the upper airway.
Of 597 patients undergoing thyroidectomy for thyroid cancer, 40 were found to have laryngotracheal invasion. Thirty-five patients with superficial invasion underwent cartilage shave procedures with adjuvant radiotherapy; five with full-thickness invasion underwent radical resection, including tracheal sleeve resection (n = 3) or total laryngectomy (n = 2). Histologic subtypes included papillary (n = 32), follicular (n = 2), Hurthle cell (n = 1), medullary (n = 3), and anaplastic (n = 2). Of the cartilage shave group, 25 are currently alive with no evidence of disease at a mean follow-up of 81 months (range 1-290). Six developed isolated local/regional recurrence and were managed with total laryngectomy (n = 1), tracheal resection (n = 1), cervical lymphadenectomy (n = 1), or repeat radiotherapy (n = 3). All six patients remain free of disease at a mean follow-up of 5 years. Of those who underwent initial laryngotracheal resection, four remain free of disease at a mean follow-up of 5 years. The rates of 10-year disease-free survival and overall survival for all patients were 47.9% (95% confidence interval [CI] 24.8, 71.0) and 83.9% (95% CI 70.3, 97.5), respectively.
These data suggest that adequate management of thyroid cancer with laryngotracheal invasion can be achieved with a more conservative surgical approach and adjuvant radiotherapy, reserving more radical resections for extensive primary lesions or locally recurrent disease.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1007/bf02305553</identifier><identifier>PMID: 9259967</identifier><language>eng</language><publisher>United States: Springer Nature B.V</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cartilage ; Cervix ; Child ; Child, Preschool ; Disease-Free Survival ; Female ; Health risk assessment ; Humans ; Laryngectomy ; Larynx - pathology ; Larynx - surgery ; Male ; Middle Aged ; Neoplasm Invasiveness ; Prognosis ; Radiation therapy ; Respiratory tract ; Retrospective Studies ; Survival Rate ; Thyroid cancer ; Thyroid Neoplasms - mortality ; Thyroid Neoplasms - pathology ; Thyroid Neoplasms - surgery ; Thyroidectomy ; Trachea - pathology ; Trachea - surgery</subject><ispartof>Annals of surgical oncology, 1997-07, Vol.4 (5), p.403-408</ispartof><rights>The Society of Surgical Oncology, Inc. 1997.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c376t-b09da3016327dd7871e8979595bff5c198f75be6c2c22c2cb088dd3deebdeb773</citedby><cites>FETCH-LOGICAL-c376t-b09da3016327dd7871e8979595bff5c198f75be6c2c22c2cb088dd3deebdeb773</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27926,27927</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9259967$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McCarty, T M</creatorcontrib><creatorcontrib>Kuhn, J A</creatorcontrib><creatorcontrib>Williams, Jr, W L</creatorcontrib><creatorcontrib>Ellenhorn, J D</creatorcontrib><creatorcontrib>O'Brien, J C</creatorcontrib><creatorcontrib>Preskitt, J T</creatorcontrib><creatorcontrib>Lieberman, Z H</creatorcontrib><creatorcontrib>Stephens, J</creatorcontrib><creatorcontrib>Odom-Maryon, T</creatorcontrib><creatorcontrib>Clarke, K G</creatorcontrib><creatorcontrib>Wagman, L D</creatorcontrib><title>Surgical management of thyroid cancer invading the airway</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><description>Locally advanced thyroid cancer invading the tracheal cartilage represents a difficult treatment dilemma during thyroidectomy.
A retrospective chart review was performed to determine the results of laryngotracheal resection or tracheal cartilage shave with adjuvant radiotherapy in patients with locally advanced thyroid cancer invading the upper airway.
Of 597 patients undergoing thyroidectomy for thyroid cancer, 40 were found to have laryngotracheal invasion. Thirty-five patients with superficial invasion underwent cartilage shave procedures with adjuvant radiotherapy; five with full-thickness invasion underwent radical resection, including tracheal sleeve resection (n = 3) or total laryngectomy (n = 2). Histologic subtypes included papillary (n = 32), follicular (n = 2), Hurthle cell (n = 1), medullary (n = 3), and anaplastic (n = 2). Of the cartilage shave group, 25 are currently alive with no evidence of disease at a mean follow-up of 81 months (range 1-290). Six developed isolated local/regional recurrence and were managed with total laryngectomy (n = 1), tracheal resection (n = 1), cervical lymphadenectomy (n = 1), or repeat radiotherapy (n = 3). All six patients remain free of disease at a mean follow-up of 5 years. Of those who underwent initial laryngotracheal resection, four remain free of disease at a mean follow-up of 5 years. The rates of 10-year disease-free survival and overall survival for all patients were 47.9% (95% confidence interval [CI] 24.8, 71.0) and 83.9% (95% CI 70.3, 97.5), respectively.
These data suggest that adequate management of thyroid cancer with laryngotracheal invasion can be achieved with a more conservative surgical approach and adjuvant radiotherapy, reserving more radical resections for extensive primary lesions or locally recurrent disease.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cartilage</subject><subject>Cervix</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Laryngectomy</subject><subject>Larynx - pathology</subject><subject>Larynx - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Invasiveness</subject><subject>Prognosis</subject><subject>Radiation therapy</subject><subject>Respiratory tract</subject><subject>Retrospective Studies</subject><subject>Survival Rate</subject><subject>Thyroid cancer</subject><subject>Thyroid Neoplasms - mortality</subject><subject>Thyroid Neoplasms - pathology</subject><subject>Thyroid Neoplasms - surgery</subject><subject>Thyroidectomy</subject><subject>Trachea - pathology</subject><subject>Trachea - surgery</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkMtLAzEQh4MotVYv3oUFwYOwmscm2Ry1WBUKHtTzksekbtlHTXaV_vdGrB4cBmYYPn4MH0KnBF8RjOW18ZgyzDlne2hKOCvyQpRkP-1YlLmigh-ioxjXGBOZuAmaKMqVEnKK1PMYVrXVTdbqTq-ghW7Iep8Nb9vQ1y6zurMQsrr70K7uVukOma7Dp94eowOvmwgnuzlDr4u7l_lDvny6f5zfLHPLpBhyg5XTDBPBqHROlpJAqaTiihvvuSWq9JIbEJZamtoaXJbOMQdgHBgp2Qxd_ORuQv8-Qhyqto4WmkZ30I-xkopSylLN0Pk_cN2PoUu_VbQgnAtFCpKoyx_Khj7GAL7ahLrVYVsRXH3brG4XvzYTfLaLHE0L7g_d6WNfF_JuEQ</recordid><startdate>19970701</startdate><enddate>19970701</enddate><creator>McCarty, T M</creator><creator>Kuhn, J A</creator><creator>Williams, Jr, W L</creator><creator>Ellenhorn, J D</creator><creator>O'Brien, J C</creator><creator>Preskitt, J T</creator><creator>Lieberman, Z H</creator><creator>Stephens, J</creator><creator>Odom-Maryon, T</creator><creator>Clarke, K G</creator><creator>Wagman, L D</creator><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>19970701</creationdate><title>Surgical management of thyroid cancer invading the airway</title><author>McCarty, T M ; Kuhn, J A ; Williams, Jr, W L ; Ellenhorn, J D ; O'Brien, J C ; Preskitt, J T ; Lieberman, Z H ; Stephens, J ; Odom-Maryon, T ; Clarke, K G ; Wagman, L D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c376t-b09da3016327dd7871e8979595bff5c198f75be6c2c22c2cb088dd3deebdeb773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cartilage</topic><topic>Cervix</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Laryngectomy</topic><topic>Larynx - pathology</topic><topic>Larynx - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Invasiveness</topic><topic>Prognosis</topic><topic>Radiation therapy</topic><topic>Respiratory tract</topic><topic>Retrospective Studies</topic><topic>Survival Rate</topic><topic>Thyroid cancer</topic><topic>Thyroid Neoplasms - mortality</topic><topic>Thyroid Neoplasms - pathology</topic><topic>Thyroid Neoplasms - surgery</topic><topic>Thyroidectomy</topic><topic>Trachea - pathology</topic><topic>Trachea - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McCarty, T M</creatorcontrib><creatorcontrib>Kuhn, J A</creatorcontrib><creatorcontrib>Williams, Jr, W L</creatorcontrib><creatorcontrib>Ellenhorn, J D</creatorcontrib><creatorcontrib>O'Brien, J C</creatorcontrib><creatorcontrib>Preskitt, J T</creatorcontrib><creatorcontrib>Lieberman, Z H</creatorcontrib><creatorcontrib>Stephens, J</creatorcontrib><creatorcontrib>Odom-Maryon, T</creatorcontrib><creatorcontrib>Clarke, K G</creatorcontrib><creatorcontrib>Wagman, L D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McCarty, T M</au><au>Kuhn, J A</au><au>Williams, Jr, W L</au><au>Ellenhorn, J D</au><au>O'Brien, J C</au><au>Preskitt, J T</au><au>Lieberman, Z H</au><au>Stephens, J</au><au>Odom-Maryon, T</au><au>Clarke, K G</au><au>Wagman, L D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical management of thyroid cancer invading the airway</atitle><jtitle>Annals of surgical oncology</jtitle><addtitle>Ann Surg Oncol</addtitle><date>1997-07-01</date><risdate>1997</risdate><volume>4</volume><issue>5</issue><spage>403</spage><epage>408</epage><pages>403-408</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Locally advanced thyroid cancer invading the tracheal cartilage represents a difficult treatment dilemma during thyroidectomy.
A retrospective chart review was performed to determine the results of laryngotracheal resection or tracheal cartilage shave with adjuvant radiotherapy in patients with locally advanced thyroid cancer invading the upper airway.
Of 597 patients undergoing thyroidectomy for thyroid cancer, 40 were found to have laryngotracheal invasion. Thirty-five patients with superficial invasion underwent cartilage shave procedures with adjuvant radiotherapy; five with full-thickness invasion underwent radical resection, including tracheal sleeve resection (n = 3) or total laryngectomy (n = 2). Histologic subtypes included papillary (n = 32), follicular (n = 2), Hurthle cell (n = 1), medullary (n = 3), and anaplastic (n = 2). Of the cartilage shave group, 25 are currently alive with no evidence of disease at a mean follow-up of 81 months (range 1-290). Six developed isolated local/regional recurrence and were managed with total laryngectomy (n = 1), tracheal resection (n = 1), cervical lymphadenectomy (n = 1), or repeat radiotherapy (n = 3). All six patients remain free of disease at a mean follow-up of 5 years. Of those who underwent initial laryngotracheal resection, four remain free of disease at a mean follow-up of 5 years. The rates of 10-year disease-free survival and overall survival for all patients were 47.9% (95% confidence interval [CI] 24.8, 71.0) and 83.9% (95% CI 70.3, 97.5), respectively.
These data suggest that adequate management of thyroid cancer with laryngotracheal invasion can be achieved with a more conservative surgical approach and adjuvant radiotherapy, reserving more radical resections for extensive primary lesions or locally recurrent disease.</abstract><cop>United States</cop><pub>Springer Nature B.V</pub><pmid>9259967</pmid><doi>10.1007/bf02305553</doi><tpages>6</tpages></addata></record> |
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subjects | Adolescent Adult Aged Aged, 80 and over Cartilage Cervix Child Child, Preschool Disease-Free Survival Female Health risk assessment Humans Laryngectomy Larynx - pathology Larynx - surgery Male Middle Aged Neoplasm Invasiveness Prognosis Radiation therapy Respiratory tract Retrospective Studies Survival Rate Thyroid cancer Thyroid Neoplasms - mortality Thyroid Neoplasms - pathology Thyroid Neoplasms - surgery Thyroidectomy Trachea - pathology Trachea - surgery |
title | Surgical management of thyroid cancer invading the airway |
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