Thyroidectomy in laryngectomy-rationale and extent

Authors

  • Subbiah Shanmugam Department of Surgical Oncology, Government Royapettah hospital, Chennai, Tamil Nadu, India
  • Saktheeswaran Raja Department of Surgical Oncology, Government Royapettah hospital, Chennai, Tamil Nadu, India http://orcid.org/0000-0003-0100-3310

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20221647

Keywords:

Thyroid gland, Laryngeal carcinoma, Invasion, Thyroidectomy, Laryngectomy

Abstract

Background:  To study the incidence of thyroid gland invasion by laryngeal carcinoma (LC) and the risk factors that may predispose to thyroid gland involvement, aiding the surgeons to develop an evidence-based plan for the management of the thyroid gland during total laryngectomy.

Methods: A retrospective analysis of patients with carcinoma larynx treated at government Royapettah hospital, Chennai between January 1, 2013, and December 31, 2020, was done. The total number of final pathology reports retrieved from our hospital system for patients who met the inclusion criteria within the specified time frame was 43.

Results: The thyroid gland was found to be invaded by LC in 13 patients (30.2%). Three patients (3/13) had only microscopic involvement while 9 patients showed gross extension. Four pathological features were found to have Statistically significant association with the incidence of thyroid gland invasion by laryngeal carcinoma. Patients with primary tumor pathological stage T4a were 30/43, with 11 patients showing thyroid gland invasion. 20 patients had subglottic invasion by the LC, with 10 patients showing thyroid gland invasion. Poorly differentiated carcinoma incidence was 13, with 9 patients showing thyroid gland infiltration.

Conclusions: 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.

References

Sparano A, Chernock R, Laccourreye O. Predictors of thyroid gland invasion in glottic squamous cell carcinoma. Laryngoscope. 2005;115:1247-50.

Biel MA, Maisel RH. Indications for performing hemithyroidectomy for tumours requiring total laryngectomy. Arch Otolaryngol Head Neck Surg. 1985;150:435-9.

Brennan JA, Meyers AD, Jafek BW. The intraoperative management of the thyroid gland during laryngectomy. Laryngoscope. 1991;101(9):929-34.

Elliot MS, Odell EW, Tysome JR. Role of thyroidectomy in advanced laryngeal and pharyngolaryngeal carcinoma. Otolaryngol Head Neck Surg. 2010;142:851-5.

Smolarz K, Malke G, Voth E, Scheidhauer K, Eckel HE, Jungehulsing M et al. Hypothyroidism after therapy for larynx and pharynx carcinoma. Thyroid. 2000;10:425-9.

Lo Galbo AM, de Bree R, Kuik DJ, Lips PT, Mary B, Von Blomberg E et al. The prevalence of hypothyroidism after treatment for laryngeal and hypopharyngeal carcinomas: are autoantibodies of influence? Acta Otolaryngol. 2007;127(3):312-7.

Sinard RJ, Tobin EJ, Mazzaferri EL, Hodgson SE, Young DC, Kunz AL et al. Hypothyroidism after treatment for non-thyroid head and neck cancer. Arch Otolaryngol Head Neck Surg. 2000;126(5):652-7.

Nayak SP, Singh V, Dam A, Bhowmik A, Jadhav TS, Ashraf M et al. Mechanism of thyroid gland invasion in laryngeal cancer and indications for thyroidectomy. Ind J Otolaryngol Head Neck Surg, 2013;65(1):69-73.

Kumar R, Drinnan M, Robinson M, Meikle D, Stafford F, Welch A et al. Thyroid gland invasion in total laryngectomy and total laryngopharyngectomy: a systematic review and meta-analysis of the English literature. Clin Otolaryngol. 2013;38(5):372-8.

Arslanoğlu S, Eren E, Özkul Y, Ciğer E, Kopar A, Önal K et al. Management of thyroid gland invasion in laryngeal and hypopharyngeal squamous cell carcinoma. Eur Arch Oto-Rhino-Laryngol. 2016;273(2):511-5.

Gorphe P, Ben LA, Tao Y, Breuskin I, Janot F, Temam S. Evidencebased management of the thyroid gland during a total laryngectomy. Laryngoscope. 2006;125(10):2317-22.

Dequanter D, Shahla M, Paulus P, Vercruysse N, Lothaire P. The role of thyroidectomy in advanced laryngeal and pharyngolaryngeal carcinoma. Ind J Otolaryngol Head Neck Surg. 2013;65(2):181-3.

Gürbüz MK, Açikalin M, Tasar S, Çakli H, Yorulmaz G, Erdinç M et al. Clinical effectiveness of thyroidectomy on the management of locally advanced laryngeal cancer. Auris Nasus Larynx. 2014;41(1):69-75.

Kim JW, Han GS, Byun SS, Lee DY, Cho BH, Kim YM. Management of thyroid gland invasion in laryngopharyngeal cancer. Auris Nasus Larynx. 2008;35(2):209-12.

Mendelson AA, Al-Khatib TA, Julien M, Payne RJ, Black MJ, Hier MP. Thyroid gland management in total laryngectomy: meta-analysis and surgical recommendations. Otolaryngol Head Neck Surg. 2009;140(3):298-305.

Mourad M, Saman M, Sawhney R, Ducic Y. Management of the thyroid gland during total laryngectomy in patients with laryngeal squamous cell carcinoma. Laryngoscope. 2015;125(8):1835-8.

Léon X, Gras JR, Pérez A, Rodríguez J, De Andrés L, Orús C et al. Hypothyroidism in patients treated with total laryngectomy. A multivariate study. Eur Arch Otorhinolaryngol. 2002;259(4):193-6.

Duntas LH, Jonklaas J. Levothyroxine dose adjustment to optimise therapy throughout a patient’s lifetime. Adv Ther. 2019;36(2):30-46.

Li SX, Polacco MA, Gosselin BJ, Harrington LX, Titus AJ, Paydarfar JA. Management of the thyroid gland during laryngectomy. J Laryngol Otol Cambridge University Press. 2017;740-4.

Păduraru DN, Ion D, Carsote M, Andronic O, Bolocan A. Post thyroidectomy hypocalcemia-risk factors and management. Chirurgia (Bucur). 2019;114(5):564-70.

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Published

2022-06-24

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Original Research Articles