One of the complications of the treatment of head and neck carcinoma patients is hypothyroidism. The objective of our study was to quantify the prevalence of hypothyroidism in patients with laryngeal or hypopharyngeal cancer treated with a total laryngectomy and to evaluate the importance of different variables in the appearance of hypothyroidism in this group of patients. A transversal study in 182 patients treated with total laryngectomy between 1986 and 1998 was carried out. TSH and FT4 were determined in all patients. Hypothyroidism was classified as subclinical (increased TSH and normal T4 levels) and clinical (increased TSH and decreased T4 levels). Univariate and multivariate analysis was carried out to examine the relationship between hypothyroidism and different variables. Our results showed that the prevalence of hypothyroidism in our group of patients was 52% (27% subclinical and 25% clinical). Sex, initial extension of the tumour, hemithyroidectomy, use of chemotherapy and radiotherapy were variables associated with the appearance of hypothyroidism in the univariate analysis (P < 0.05). When all these variables were included in a multivariate study, only hemithyroidectomy (RR 3,6; CI 95% 1,7-7,2) and combined treatment with radiotherapy (RR 3,4; CI 95% 1,2-9,6) appeared as prognostic factors. In conclusion, hypothyroidism is a frequent complication in patients treated with a total laryngectomy (52%), especially when this treatment includes hemithyroidectomy and/or radiotherapy. We consider that it is important to check the thyroid function periodically in these patients to obtain early diagnosis and appropriate treatment.

Our results indicate that CDDP-FU is more effective than CBDCA-FU as neoadjuvant treatment in stage IV-M0 head and neck cancer.

No abstract

Fifty consecutive cases of male breast cancer (MBC) treated in a single institution were studied. Presentation of the disease, histology, pattern of relapse, and major prognostic factors were similar to those known in female breast cancer (FBC). Five-year disease-free interval and survival were 59% and 75% respectively. Endocrine therapy for treatment of metastatic MBC was proven to be effective with a response rate of about 50% of patients, unselected with regard to oestrogen receptors. A group of patients receiving adjuvant treatment showed lower recurrence rate and a trend toward better outcome than similar stage patients without adjuvant treatment. The present study combined with the recent literature suggests that MBC and FBC are biologically comparable and that inference from experience in treatment of FBC may be justified.