Does Thyroid Gland Preserving Total Laryngectomy Affect Oncological Control in Laryngeal Carcinoma?

2019 ◽  
Vol 130 (6) ◽  
pp. 1465-1469 ◽  
Author(s):  
Jessica K. McGuire ◽  
Gerrit Viljoen ◽  
John Rocke ◽  
Siobhan Fitzpatrick ◽  
Sameera Dalvie ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Laryngeal Carcinoma ◽  
Total Laryngectomy

Thyroid Gland Management in Total Laryngectomy: Meta-analysis

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P46-P47
Author(s):  
Asher Aron Mendelson ◽  
Talal Ahmed Al-Khatib ◽  
Marilyse Julien ◽  
Michael P Hier
Keyword(s):  
Thyroid Gland ◽  
Total Thyroidectomy ◽  
Squamous Cell ◽  
Laryngeal Carcinoma ◽  
Total Laryngectomy ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Total N ◽  
Laryngeal Tumors ◽  
Subglottic Extension

Objective 1. Review the incidence of thyroid gland invasion by squamous cell laryngeal carcinoma in the literature. 2. Correlate thyroid gland invasion with anatomical characteristics of the laryngeal tumor. Do laryngeal tumors which invade the thyroid gland share certain characteristics which can aid in determing the management of the thyroid gland during total laryngectomy? Methods Systematic review of MEDLINE (1967–2007) and EMBASE (1980–2007) for all total laryngectomy series which commented on thyroid gland invasion according to tumor subsite and pathological characteristics. These results were supplemented with 61 patients from our centers who underwent total laryngectomy with hemi- or total thyroidectomy. Eleven series in total (n = 535) were included in the meta-analysis (fixed effects model). Results Thyroid gland invasion was present in 47 laryngectomy specimens (9%); the main method of invasion of the gland was by direct extralaryngeal extension. Subglottic extension > 10mm (OR 6.27 [2.16 to 18.19]; p = 0.0007), subglottic subsite (OR 4.32 [1.53 to 12.19]; p = 0.006), and transglottic subsite (OR 4.10 [1.75 to 9.57]; p = 0.001) were significantly correlated with thyroid gland invasion. Cartilagenous invasion by tumor was not a significant predictor of thyroid gland invasion (p>0.05). Conclusions Thyroid gland invasion is not a general feature of squamous cell laryngeal carcinoma. When present, it is strongly associated with anteroinferior spread of laryngeal tumors. Thyroidectomy should only be performed during total laryngectomy for transglottic tumors, subglottic tumors, and tumors with subglottic extension >10mm. In these cases, total thyroidectomy is warranted to maximize locoregional control.

scholarly journals Incidence and predictors of thyroid gland invasion by laryngeal carcinoma: a 7-year experience review

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Ahmad M. Eltelety ◽  
Ahmed A. Nassar ◽  
Ahmed M. El Batawi ◽  
Sherif G. Ibrahim
Keyword(s):  
Risk Factors ◽  
Thyroid Gland ◽  
Total Thyroidectomy ◽  
Primary Tumor ◽  
Laryngeal Carcinoma ◽  
Total Laryngectomy ◽  
Tumor Stage ◽  
Significant Incidence ◽  
Poorly Differentiated ◽  
Subglottic Extension

Abstract Background Study the incidence of thyroid gland invasion by laryngeal carcinoma and the risk factors that may predispose to this condition. Aiding surgeons develop an evidence-based plan for the management of the thyroid gland during total laryngectomy. Results Retrospective analysis of the available medical records for patients who had total laryngectomy together with total thyroidectomy or hemithyroidectomy in the same procedure. Associated pathological features were also investigated. Patients who had laryngeal carcinoma managed by total laryngectomy with total thyroidectomy or hemithyroidectomy between January 1, 2011, and December 31, 2017. Three hundred seventy-seven records were retrieved. The incidence of thyroid gland invasion by the laryngeal carcinoma was 24 (6.4%). Three patients showed microscopic extension (3/356; 0.8%). Six patients had malignant pathology other than squamous cell carcinoma (SCC). Two over six had invasion of the thyroid gland; OR (95% CI): 7.9 (1.4-45.4). Patients who had primary tumor stage of T4a were 244. 23/244 had thyroid gland invasion, 13.7 (1.8-102.9). Poorly differentiated tumors had significant incidence of thyroid gland invasion (4/15), 6.2 (1.8-21.3). Patients who had subglottic extension by the primary tumor were 177 with 20 patients having thyroid gland invasion (20/177), 6.2 (2.1-18.6). Conclusion Several risk factors are associated with higher incidence of invasion of the thyroid gland by laryngeal carcinoma. Identification of these factors can help surgeons develop a surgical strategy for the management of the thyroid gland during total laryngectomy.

scholarly journals Thyroid Gland Invasion in Laryngeal Carcinoma

2018 ◽  
Vol 32 (2) ◽  
pp. 22-24 ◽  
Author(s):  
Maria Concepcion F. Vitamog ◽  
Samantha S. Castañeda
Keyword(s):  
Thyroid Gland ◽  
Total Thyroidectomy ◽  
Laryngeal Carcinoma ◽  
Total Laryngectomy ◽  
Thyroid Cartilage ◽  
Case Series ◽  
Government Hospital ◽  
Retrospective Case ◽  
Cartilage Invasion ◽  
Poorly Differentiated

Objective: To determine the prevalence of, and describe transglottic cancer with thyroid cartilage invasion as a possible risk for, thyroid gland invasion in a series of patients with laryngeal carcinoma who underwent total laryngectomy with thyroidectomy. Methods Study Design:            Retrospective case series Setting:                       Tertiary government hospital Subjects:                    61 laryngeal carcinoma patients who underwent total laryngectomy with hemi- or total thyroidectomy from January 2010 to August 2017. Results Out of 61 patients with laryngeal carcinoma, 11 patients had supraglottic, 11 glottic, 2 subglottic and 37 had transglottic involvement. Eleven had thyroid cartilage invasion, all of whom had transglottic tumors. Of these 11 patients, only 1 had thyroid gland invasion. This was a case of a 78 year-old male patient, with poorly differentiated SCC stage IVa transglottic tumor with thyroid cartilage invasion. Conclusion Thyroid gland invasion was uncommon in our sample of laryngeal carcinoma patients who underwent laryngectomy and thyroidectomy. Although transglottic involvement with thyroid cartilage invasion may increase the risk of thyroid gland invasion, it could not be confirmed by our series. Perhaps thyroidectomy should not be routinely performed on all patients with laryngeal carcinoma who undergo total laryngectomy, but more rigorous studies are needed to establish this.   Keywords: laryngeal carcinoma, transglottic, thyroid cartilage invasion, thyroid gland invasion, thyroidectomy  

Does thyroid-sparing total laryngectomy decrease the risk of hypothyroidism?

2020 ◽  
pp. 1-4
Author(s):  
G Viljoen ◽  
J K McGuire ◽  
A Alhadad ◽  
S Dalvie ◽  
J J Fagan
Keyword(s):  
South Africa ◽  
Retrospective Study ◽  
Laryngeal Carcinoma ◽  
Adjuvant Radiotherapy ◽  
Total Laryngectomy ◽  
Inclusion Criteria ◽  
Nccn Guidelines ◽  
Thyroid Lobectomy ◽  
Cancer Network ◽  
Advanced Laryngeal Carcinoma

Abstract Background Thyroid lobectomy is recommended with total laryngectomy for laryngeal cancer in the National Comprehensive Cancer Network (‘NCCN’) guidelines. However, it is associated with a 32–89 per cent risk of hypothyroidism, with or without adjuvant radiotherapy. Objective The study aimed to determine whether preserving the whole thyroid, compared to a single lobe, does indeed significantly lower the incidence of hypothyroidism in the setting of total laryngectomy. Method A retrospective study was conducted at Groote Schuur Hospital in Cape Town, South Africa. Results Eighty-four patients met the inclusion criteria. The overall incidence of hypothyroidism was 45.2 per cent. The incidence of hypothyroidism was significantly reduced in patients who underwent thyroid-sparing total laryngectomy compared to hemithyroidectomy (p = 0.037). Adjuvant radiotherapy was associated with a higher incidence of hypothyroidism (p = 0.001). Conclusion Thyroid-preserving laryngectomy should be advocated in carefully selected patients with advanced laryngeal carcinoma, as it reduces the incidence of hypothyroidism.

scholarly journals Radical surgery of the malignantlaryngeal tumors

2004 ◽  
Vol 51 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Vladimir Djordjevic ◽  
Jovica Milovanovic ◽  
Zeljko Petrovic ◽  
Zoran Dudvarski ◽  
B. Petrovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Survival Rate ◽  
Patient Group ◽  
Reconstructive Surgery ◽  
Laryngeal Carcinoma ◽  
Total Laryngectomy ◽  
Radical Surgery ◽  
Salvage Surgery ◽  
Medical Documentation ◽  
Operative Methods

Modem therapeutical protocols for treatment of T3 and T 4 malignomas of the larynx are not adjusted, because there are attempts to treat these diseases with non-operative methods (such as chemo- and radiotherapy) in order to preserve the organ. The aim of the study was to establish today's results of the surgical treatment of patients with T3 and T4 laryngeal malignoma. We studied the group of patients with laryngeal carcinoma, who had undergone total laryngectomy, during the period of eight years (1990-1997). The patients' data was submitted from medical documentation, it was filled in specially designed questionnaires and was statistically reviewed. During this eight-year-period. 1054 total laryngectomies were done. The five-years survival rate, established in the group of patients who had undergone total laryngectomiy is 308/794 (39%). In the patient group where total laryngectomy was salvage surgery after radiotherapy, the five-years survival rate is 47/172 (27%). In the patient group where total laryngectomy was salvage surgery after conservative or reconstructive surgery, the five-years survival rate is 28/84 (33%). Despite diagnostical and therapeutical achievements, prognosis for T3 and T4 malygnoma of the larynx was not significantly approved in the last few decades.

Evidence‐based management of the thyroid gland during a total laryngectomy

2015 ◽  
Vol 125 (10) ◽  
pp. 2317-2322 ◽  
Author(s):  
Philippe Gorphe ◽  
Aïcha Ben Lakhdar ◽  
Yungan Tao ◽  
Ingrid Breuskin ◽  
François Janot ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Total Laryngectomy ◽  
Evidence Based

Total Laryngectomy

2010 ◽  
Vol 2 (3) ◽  
pp. 207-214 ◽  
Author(s):  
Arash Mohebati ◽  
Jatin P Shah
Keyword(s):  
Surgical Procedures ◽  
Laryngeal Carcinoma ◽  
Total Laryngectomy ◽  
Organ Preservation ◽  
Standard Of Care ◽  
Cartilage Destruction ◽  
Salvage Procedure ◽  
Voice Restoration ◽  
Function Preservation

Abstract Total laryngectomy since it was first performed more than a century ago has undergone numerous modifications with increasing attention to voice restoration. Function preservation has also been achieved by voice sparing surgical procedures, and organ preservation strategies with chemoradiotherapy for laryngeal carcinoma. However, total laryngectomy remains the standard of care for very advanced laryngeal cancers with cartilage destruction, and as a salvage procedure for failures to organ preservation therapies. In this article, we review the indications, complications and outcomes of total laryngectomy in the era of chemoradiotherapy.

Thyroid and parathyroid dysfunction after total laryngectomy in patients with laryngeal carcinoma

2016 ◽  
Vol 273 (10) ◽  
pp. 3237-3241 ◽  
Author(s):  
Hesham Negm ◽  
Mohamed Mosleh ◽  
Hesham Fathy ◽  
Ahmed Awad
Keyword(s):  
Laryngeal Carcinoma ◽  
Total Laryngectomy ◽  
Parathyroid Dysfunction
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