The role of adjuvant external beam radiation therapy for papillary thyroid carcinoma invading the trachea

Kim, Young Suk; Choi, Jae Hyuck; Kim, Kwang Sik; Lim, Gil Chai; Kim, Jeong Hong; Kang, Joon Wun; Song, Hee-Sung; Lee, Sang Ah; Hyun, Chang Lim; Kim, Gwi Eon

doi:10.3857/roj.2017.00192

Cited by 16 publications

(19 citation statements)

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“…In one study of thyroidectomy, lymph node dissection and shave resection of the trachea with radioactive iodine and selected adjuvant external beam radiation, all patients experienced dysphagia after radiation (125). Hospital mortality ranged from 0.02% to 1.4% in this group.…”

Section: Assessment Of Complicationsmentioning

confidence: 94%

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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: Assessment Of Complicationsmentioning

confidence: 94%

“…Median 5-year survival in patients with thyroid malignancy was 74.2% [range, <10% after shave resection (29) to 100%]. (6)(7)(8)17,36,53,58,73,121,(125)(126)(127)(128)(129)(130)(131)(132)(133)(134)] …”

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confidence: 99%

Secondary tracheal tumors: a systematic review

Madariaga¹,

Gaissert²

2018

Ann. Cardiothorac. Surg.

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“…Adjuvant RT has proven effective in reducing LRR in patients who have high-risk factors, such as locally invasive tumors, multiple lymph node )LN( metastases, and microscopic or macroscopic residual disease. [4][5][6][7][8][9] However, only a few studies have reported the survival benefits of ART for recurrent PTC. 10 The difference in survival outcomes between patients with locoregionally recurrent PTC who received ART and those who did not receive ART after salvage surgery has not been wellstudied.…”

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confidence: 99%

The role of adjuvant radiation therapy for locoregionally recurrent papillary thyroid carcinoma

Hwang

Lee

2021

SMJ

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To evaluate the role of adjuvant radiation therapy in patients with locoregionally recurrent )rpT4/N1b( papillary thyroid carcinoma )PTC(. Methods:The medical records of patients with rpT4/ N1b PTC who were treated between January 2001 and December 2016 were reviewed. A total of 57 patients were analyzed, of which 24 patients were treated with adjuvant radiation therapy, and 33 patients did not receive adjuvant radiation therapy. Survival outcomes were compared between the 2 treatment groups. The primary endpoint was locoregional recurrence-free survival rate. Original ArticleResults: The median follow-up period for all patients was 10.3 years )range, 2.8-19.2 years(. The 15-year locoregional recurrence-free survival rate was 80.5% for those who received adjuvant radiation therapy and 28.1% for those who did not )p<0.001(. The 15-year distant metastasis-free survival rate was 48.8% for those who received adjuvant radiation therapy and 33.4% for those who did not )p=0.906(. The 15-year overall survival rate was 69.7% for those who received adjuvant radiation therapy and 53.1% for those who did not )p=0.921(. Conclusion:Adjuvant radiation therapy ensured favorable locoregional recurrence-free survival in patients with rT4/N1b PTC and might contribute to improving patients' quality of life by reducing the need for additional salvage surgery and the economic burden of other salvage treatments, such as surgery or radioactive iodine therapy.

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“…Such conservative approaches depend on postoperative RAI administration with or without EBRT to manage microscopic disease 3 . These patients may have better local failure-free survival rate (LFFS) with Adjuvant EBRT 6 . Our patient underwent the conservative approach and had positive excision margins.…”

Section: Discussionmentioning

confidence: 99%

Haemoptysis: a presentation of papillary thyroid carcinoma

Balasubramaniam

Jayasuriya

2019

Ceylon J Otolaryngology

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Papillary thyroid carcinomas can be retrospectively diagnosed in patients, who are having metastatic disease with an occult primary lesion. A sixty-year-old female patient was investigated for haemoptysis and was found to have a tracheal lesion. Biopsy revealed a papillary carcinoma of the thyroid. Patient underwent total thyroidectomy with excision of the tracheal lesion and was followed up by adjuvant external beam radiotherapy (EBRT) and radioactive iodine (RAI) treatment. The detailed history, examination and investigations of neck and upper aerodigestive tract (ADT) are important for correct diagnosis of papillary thyroid microcarcinoma.

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The role of adjuvant external beam radiation therapy for papillary thyroid carcinoma invading the trachea

Cited by 16 publications

References 31 publications

Secondary tracheal tumors: a systematic review

Secondary tracheal tumors: a systematic review

The role of adjuvant radiation therapy for locoregionally recurrent papillary thyroid carcinoma

Haemoptysis: a presentation of papillary thyroid carcinoma

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