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. 2022 Oct;74(Suppl 2):2629-2635.
doi: 10.1007/s12070-020-02339-1. Epub 2021 Jan 7.

Circumferential Laryngotracheal Resection in Thyroid Cancer: Experience and Outcome in a Single Center

Vikram Sharanappa  1 , Raouef Ahmed Bichoo  1 , Anjali Mishra  1 , Prasanta Kumar Pradhan  2 , Saroj Kanta Mishra  1
Affiliations

Circumferential Laryngotracheal Resection in Thyroid Cancer: Experience and Outcome in a Single Center

Vikram Sharanappa et al. Indian J Otolaryngol Head Neck Surg. 2022 Oct.

Abstract

There is limited experience of laryngotracheal resection in patients with differentiated thyroid carcinoma (DTC). The aim of this study was to report our experience of circumferential laryngotracheal resection in DTC and its long-term outcome. In this retrospective study, 10 patients of locally invasive DTC who underwent circumferential laryngotracheal resection between January 2000 and December 2015 were included. Clinicopathologic profile and follow up was noted. Mean age of the cohort was 50.1 ± 7.8 years (M:F = 1: 2.3). Papillary carcinoma was the commonest pathology (60%) followed by follicular carcinoma (20%), 10% each had Hurthle cell and poorly differentiated thyroid carcinoma. Sixty percent patients presented with recurrent or persistent disease and 20% with distant metastases. Vocal cord palsy was observed in 30%. Fifty percent patients underwent tracheal resection with end to end anastomosis and remaining laryngotracheal resection. Carotid artery resection and anastomosis was performed in one patient. Shin stage IV invasion was observed in 80% and stage III in remaining. There was no perioperative mortality. All patients received adjuvant radioiodine therapy and 40% external beam radiotherapy. Median follow up was 48 months. One patient who earlier had tracheal resection underwent total laryngectomy due to recurrent disease after 24 months. Forty percent patients developed distant metastases during follow-up. Mean survival was 77.8 months (CI = 63.0-92.5). Five-year overall survival was 60% and was significantly high in those without distant metastases (p = 0.006). The outcome of circumferential larygotracheal resections for DTC is excellent in terms of local disease control and long term survival.

Keywords: DTC; Locally advanced thyroid cancer; Shin classification.

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Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Coronal reconstruction of CECT image of a papillary thyroid carcinoma patient having Shin Stage IV invasion into trachea, showing tumor invasion through left lateral wall of trachea resulting in almost complete obliteration of tracheal lumen
Fig. 2
Fig. 2
Gross specimen of the same patients wherein en block circumferential tracheal resection along with total thyroidectomy and central compartment lymph node dissection was performed
Fig. 3
Fig. 3
Kaplan–Meier curve depicting overall survival of the cohort
See this image and copyright information in PMC

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