Conservative surgical management of invasive differentiated thyroid cancer

Shvili, Y.; Zohar, Yuval; Buller, Nora; Laurian, N.

doi:10.1017/s0022215100098492

Cited by 14 publications

(10 citation statements)

References 7 publications

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“…There were 64 individual case reports and 96 case series (consisting of more than one case). Of the 96 case series, 17 series contained enough details to extract individual patient data; these 110 patients were analyzed with the individual case reports (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Forty-five case series reported exclusively on tracheal invasion by thyroid cancer (Table S1).…”

Section: Quantity Of Evidencementioning

confidence: 99%

Secondary tracheal tumors: a systematic review

Madariaga¹,

Gaissert²

2018

Ann. Cardiothorac. Surg.

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Background: Secondary tracheal tumors arise from mural invasion by primary tumors in adjacent organs, metastatic lymph nodes or blood-born metastasis from distant sites. This systematic review aims to assess the presentation, management options, and clinical outcomes of these uncommon non-tracheal malignancies.Methods: Electronic searches of the MEDLINE database were performed to identify case series and individual case reports of tracheal invasion by primary non-tracheal tumors or metastatic disease. AllEnglish-language studies with available abstracts or articles containing primary data were included.Results: From 1978 to 2017, a total of 160 case reports or case series identified 2,242 patients with invasion of the trachea by tumors of adjacent organs (n=1,853) or by metastatic lymph nodes or hematogenous spread (n=389). Common primary sites of origin were thyroid, esophagus, and lung, and the most common presentation was metachronous (range of interval: 0 to 564 months) with dyspnea, neck mass, voice change and/or hemoptysis. A majority of patients in case reports (77.9%) and case series (66.0%) underwent resection and the most common reported operation was segmental tracheal resection. Fewer patients underwent bronchoscopic intervention (21.7%) and radiation was used in 32.2% of patients. Complications after bronchoscopic treatment included bleeding, granulation tissue, and retained secretions, while anastomotic leak, unplanned tracheostomy, and new recurrent laryngeal nerve paralysis were observed after surgical resection. The rate of 30-day mortality was low (0.01-1.80%). Median survival was higher in patients with thyroid malignancy and in patients who underwent surgical management. Follow-up time ranged from 0.03 to 183 months. Conclusions:Patients with tracheal invasion by metastatic or primary non-tracheal malignancies should be assessed for symptoms, tumor grade, tumor recurrence and concurrent metastases to decide on optimal surgical, bronchoscopic or noninterventional therapy. Clinical experience suggests that palliative endoscopic intervention for tracheal obstruction by metastasis-bearing lymph nodes is underreported.Keywords: Endotracheal metastasis; secondary tracheal tumors; systematic review Submitted Nov 24, 2017. Accepted for publication Dec 21, 2017Dec 21, . doi: 10.21037/acs.2018 View this article at: http://dx.doi.org/10.21037/acs.2018.02.01 Systematic Review IntroductionSecondary tracheal tumors are defined as tumors in, but not of the trachea and comprise a wide spectrum of tumor histologies and stages. There are no populationbased data for these tumors, and in clinical practice these lesions are probably more common than primary neoplasms. A thoracic surgeon probably encounters tracheal obstruction by metastatic lymph nodes more often than invasion by adjacent primary tumors. Since natural history and prognosis are related to the tumor of origin, their management and prognosis may differ considerably from primary tracheal neoplasms; a correct diagnosis with attribution to the origi...

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Section: Quantity Of Evidencementioning

confidence: 99%

Secondary tracheal tumors: a systematic review

Madariaga¹,

Gaissert²

2018

Ann. Cardiothorac. Surg.

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“…Pouca diferenciação à reavaliação dos achados histopatológicos após a cirurgia representa um pior prognóstico 28 . Por outro lado, como o mais importante sinal prognóstico é a invasão local, a realização da ressecção da traquéia tem uma relação íntima com a evolução desses pacientes 29,30 e a extirpação cirúrgica da laringe diante de invasão tumoral local extensa permite resultados satisfatórios a longo prazo 31,32,33 . Raspagem do tumor a partir da traquéia e realização de dose terapêutica de iodo ( 131 I) ou radioterapia externa para controle do tumor residual freqüentemente fazem a recorrência manifestar-se mais tardiamente 34,35 .…”

Section: Discussionunclassified

Carcinoma papilífero de tireóide localmente invasivo

Dedivitis

Guimarães

2002

Rev. Bras. Otorrinolaringol.

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Introdução: O carcinoma bem diferenciado da tireóideinvade estruturas e tecidos moles adjacentes cervicais em uma minoria de pacientes. Entretanto, quando isso ocorre, há significativa morbidade e excessiva mortalidade. Objetivo: Análise retrospectiva dos resultados cirúrgicos. Forma de estudo: Clínico retrospectivo. Material e método: Foram submetidos à tireoidectomia 509 pacientes em nosso serviço de 1994 a 2000. Havia 71 casos de carcinoma papilífero, com 13 casos de extensão extra-tireoidiana (18,3%). Havia cinco pacientes do sexo masculino e oito do feminino, com mediana etária de 57 anos. As estruturas mais freqüentemente invadidas foram: músculos pré-tireoidianos -10 casos; traquéia -9; nervo laríngeo recorrente -6; laringe -4; e esôfago -1. Tireoidectomia total foi realizada em todos os casos, com esvaziamento cervical radical em cinco e de nível VI em seis. Anastomose término-terminal da traquéia foi realizada em cinco pacientes e anastomose entre cricóide e traquéia em dois. Um paciente foi submetido à laringectomia total. Resultados: Um paciente foi a óbito no 10º dia pós-operatório por complicações cardíacas. Dose terapêutica de 131 I foi administrada nos demais pacientes. Todos passaram a receber tiroxina em dose supressiva para a tireotrofina. Outro paciente foi a óbito por causa clínica no 14o mês pós-operatório. Um paciente recusou laringectomia total, estando vivo com doença. Oito pacientes evoluem bem, com seguimento variando de 10 a 49 meses. Um apresentou recidiva local, que foi resgatada cirurgicamente, com bom resultado.

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“…Other authors, (Friedman et al, 1982;Lawson, 1983;Shvill et al, 1985) prefer conservative surgical procedures where possible. Breaux and Guillamondegui (1980) concluded in their paper on 47 patients with locally invasive thyroid cancer, that surgery aimed at removal of all gross tumour, but with preservation of vital structures whenever possible offers a reasonable chance of cure in locally aggressive, well-differentiated thyroid cancer.…”

Section: Discussionmentioning

confidence: 99%

Hypopharyngeal involvement by thyroid cancer

Timon

Leen

Doyle-Kelly³

1989

J. Laryngol. Otol.

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Direct upper airway infiltration by thyroid neoplasia is a rare occurrence, a unique case of papillary thyroid neoplasia presenting as a pyriform fossa mass is described and the management of these problem patients is discussed, emphasising the controversy between radical and conservative surgery.The possibility that the thyroid tumour resulted from previous radioactive iodine prescribed for thyrotoxicosis is also considered.

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Conservative surgical management of invasive differentiated thyroid cancer

Cited by 14 publications

References 7 publications

Secondary tracheal tumors: a systematic review

Secondary tracheal tumors: a systematic review

Carcinoma papilífero de tireóide localmente invasivo

Hypopharyngeal involvement by thyroid cancer

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