Clinical effectiveness of thyroidectomy on the management of locally advanced laryngeal cancer

Gürbüz, Melek Kezban; Açıkalın, Mustafa Fuat; Tasar, Soner; Çaklı, Hamdi; Yorulmaz, Göknur; Erdinç, Metin; Özüdoğru, Erkan; Keçik, Cem; Çolak, Ertuğrul; Şaylısoy, Suzan

doi:10.1016/j.anl.2013.10.004

Cited by 12 publications

(24 citation statements)

References 17 publications

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“…Primary subglottic carcinomas and tumor extension to the subglottis are the best clinical predictors for thyroid gland invasion . A meta‐analysis of laryngeal carcinoma confirmed that subglottic extension of more than 10 mm and transglottic tumors increase the risk of thyroid gland invasion .…”

Section: Discussionmentioning

confidence: 95%

“…Routine thyroid sacrificing surgery with total laryngectomy is contentious. Despite thyroid lobectomy on the side of the laryngeal cancer being commonly advocated in advanced T3 and T4 laryngeal cancers and recommended in the most recent NCCN guidelines, thyroid gland invasion by laryngeal cancer is uncommon. A meta‐analysis by Kumar et al reported an overall pooled incidence of 10.7% in 1287 patients (95% confidence interval ranging from 7.6 to 14.2%) .…”

Section: Discussionmentioning

confidence: 99%

“…This is significant considering that between 32% and, with postoperative radiotherapy up to 89%, of patients with a laryngectomy and thyroid lobectomy develop postoperative hypothyroidism . Even though sparing the thyroid gland may theoretically result in lower rates of hypothyroidism, there are, however, no studies to document that this is indeed the case.…”

Section: Discussionmentioning

confidence: 99%

“…Thyroid lobectomy with total laryngectomy is associated with a 32% to 89% risk of hypothyroidism . This may be problematic if patient follow‐up is unreliable, or if the ability to monitor and treat hypothyroidism is unavailable as it is in much of the developing world …”

Section: Introductionmentioning

confidence: 99%

“…Involvement of the thyroid gland in laryngeal squamous cell carcinoma is most commonly due to extralaryngeal tumor extension or via lymphatic spread . Therefore, thyroid lobectomy on the side of the laryngeal cancer is commonly advocated in advanced T3 and T4 laryngeal cancers and is recommended in the most recent National Comprehensive Cancer Network (NCCN) guidelines . However, thyroid gland invasion by laryngeal cancer is uncommon, with an overall pooled incidence of 10.7% in centers that routinely perform partial or total thyroidectomy during a laryngectomy for T3 and T4 laryngopharyngeal cancers .…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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Introduction Thyroid lobectomy is recommended with total laryngectomy in the National Comprehensive Cancer Network guidelines. However, it is associated with a 32% to 89% risk of hypothyroidism, which is a problem for patients without access to thyroid hormone monitoring and replacement. A number of studies have reported a low incidence of thyroid gland involvement and recommended preserving the thyroid gland in favorable cases. Yet there are no studies that report whether thyroid preserving laryngectomy for laryngeal cancer adversely affects oncologic outcomes compared to patients who have undergone thyroid lobectomy. Objectives To determine whether patients who underwent thyroid gland preserving laryngectomy had higher local recurrence rates or poorer disease‐free survival. Method A retrospective folder review of patients who underwent a total laryngectomy over a 12‐year period was conducted. Local recurrence and disease‐free survival were determined for patients who had both their thyroid lobes preserved and compared with those who had a thyroid lobectomy. Results Sixty‐nine patients had thyroid preserving laryngectomy and 73 patients had a thyroid lobectomy. The duration of follow‐up was 18 to 132 months (median, 30; IQR, 30). There was no significant difference in local recurrence rates (P = .76) or survival curves between the two groups. Conclusion Thyroid preserving laryngectomy in selected patients with advanced laryngeal carcinoma does not increase local recurrence rates, nor does it negatively affect disease‐free survival. Thyroid preservation is appropriate when intraoperative inspection of the larynx shows no extralaryngeal extension or when paratracheal nodal metastases are not a concern. Level of Evidence Level 4 Laryngoscope, 130:1465–1469, 2020

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

et al. 2019

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Incidence and complications of hypothyroidism postlaryngectomy: A systematic review and meta‐analysis

Banyi,

Kwon,

Turkdogan

et al. 2023

Head & Neck

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BackgroundHypothyroidism is common postlaryngectomy and is associated with laryngectomy‐specific complications. The objective of this study is to determine the incidence and predictors of hypothyroidism postlaryngectomy and its associated complications.MethodsSystematic review, data extraction, and meta‐analyses were performed following the PRISMA protocol. Six databases were searched for studies reporting on postlaryngectomy thyroid status with incidence, risk factors, management, or complications.ResultsFifty‐one studies with 6333 patients were included. The pooled incidence of postlaryngectomy hypothyroidism is 49% (CI 42%–57%). Subgroup analysis showed postlaryngectomy hypothyroidism rates significantly correlated with hemithyroidectomy and radiotherapy. Patients who underwent laryngectomy, hemithyroidectomy, and radiotherapy had a 65% (CI 59%–71%) rate of hypothyroidism; laryngectomy and hemithyroidectomy 46% (CI 33%–60%); laryngectomy and radiotherapy 26% (CI 19%–35%); and laryngectomy alone 11% (CI 4%–27%) (p < 0.001).ConclusionsLaryngectomized patients with partial thyroidectomy or radiation therapy are at significant risk of postoperative hypothyroidism. Evidence‐based protocols for early detection and (prophylactic) treatment should be established.

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The predictive value of MRI in detecting thyroid gland invasion in patients with advanced laryngeal or hypopharyngeal carcinoma

Lin¹,

Huang²,

Zheng³

et al. 2016

Eur Arch Otorhinolaryngol

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The aim of this study was to evaluate the predictive value of magnetic resonance imaging (MRI) in detecting thyroid gland invasion (TGI) in patients with advanced laryngeal or hypopharyngeal carcinoma. In a retrospective chart review, 41 patients with advanced laryngeal or hypopharyngeal carcinoma underwent MRI scan before total laryngectomy and ipsilateral or bilateral thyroidectomy during the past 5 years. The MRI findings were compared with the postoperative pathological results. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Among the 41 patients, 3 had thyroid gland invasion in postoperative pathological results. MRI correctly predicted the absence of TGI in 37 of 38 patients and TGI in all 3 patients. The sensitivity, specificity, PPV, and NPV of MRI were 100.0, 97.4, 75.0, and 100 %, respectively, with the diagnostic accuracy of 97.6 %. In consideration of the high negative predictive value of MRI, it may help surgeons selectively preserve thyroid gland in total laryngectomy and reduce the incidence of hypothyroidism and hypoparathyroidism postoperatively.

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Clinical effectiveness of thyroidectomy on the management of locally advanced laryngeal cancer

Cited by 12 publications

References 17 publications

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

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

Incidence and complications of hypothyroidism postlaryngectomy: A systematic review and meta‐analysis

The predictive value of MRI in detecting thyroid gland invasion in patients with advanced laryngeal or hypopharyngeal carcinoma

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