Evaluation of The Necessity of The Thyroidectomy in Patients Undergoing Total Laryngectomy: A Single Center Experience

Abstract

Objective: This study aimed to evaluate the necessity of thyroidectomy in patients undergoing total laryngectomy in a single-center experience. It focused on determining the incidence of thyroid gland invasion and its relationship with tumor stage and localization, and to assess whether routine or selective thyroidectomy is justified. Materials and methods: We retrospectively analyzed patients who underwent total laryngectomy between 2019 and 2025. Demographic and clinical data including age, gender, T stage, primary tumor localization, cervical lymph node metastasis, and the addition of thyroid gland excision were evaluated to determine factors associated with thyroidectomy during surgery. Results: The mean age of the patients (62 male and 4 female) was 65.9±9. Eight patients had stage T1, 33 T2, 18 T3, and 7 T4. 16 patients had supraglottic, 26 glottic, 20 transglottic and 4 patients had subglottic cancer. 15 patients had lymph node metastasis. In 26 patients, a lobectomy and in 7 patients total thyroidectomy was performed. Conclusion: In our clinic, total laryngectomy is generally preferred for T4a laryngeal tumors, selected T3 supraglottic tumors with high tumor burden and impaired pulmonary function, and transglottic tumors. Based on our findings, thyroid gland invasion is uncommon, and therefore the addition of thyroidectomy to total laryngectomy should not be routine but rather performed selectively according to tumor stage and extension. Keywords: laryngeal cancer, laryngectomy, thyroidectomy, metastasis

Keywords

• laryngeal cancer
• laryngectomy
• thyroidectomy
• metastasis

Supporting Institution

None

Ethical Statement

The study was approved by the Scientific Research Ethics Committee of Adana City Training and Research Hospital (Date: 30.03.2026, Number: 1251) and was conducted by the 2013 Declaration of Helsinki.

Total Larenjektomi Yapılan Hastalarda Tiroidektomi Gerekliliğinin Değerlendirilmesi: Bir Tek Merkez Deneyimi

Abstract

Amaç: Bu çalışma, total larenjektomi geçiren hastalarda tiroidektominin gereklililiğini değerlendirmeyi amaçlayan tek merkezli bir çalışmadır. Tiroid invazyonunun sıklığı, tümör evresi ve lokalizasyonu ile ilişkisini ve rutin veya selektif tiroidektominin haklılığını değerlendirmeye odaklanmıştır. Yöntem: 2019 ile 2025 yılları arasında total larenjektomi uygulanan retrospektif olarak analiz ettik. Yaş, cinsiyet, T evresi, primer tümör lokalizasyonu, servikal lenf düğümü metastazı ve tiroid bezi eklenmesi gibi demografik ve klinik veriler, ameliyat sırasında tiroidektomi ile ilişkili faktörleri belirlemek için değerlendirildi. Bulgular: Çalışmaya 62’si erkek, 4’ü kadın olmak üzere toplam 66 hasta dahil edildi. Ortalama yaş 65,9±9 yıl idi. Sekiz hasta T1, 33 hasta T2, 18 hasta T3 ve 7 hasta T4 evresindeydi. Tümör lokalizasyonu 16 hastada supraglottik, 26 hastada glottik, 20 hastada transglottik ve 4 hastada subglottik olarak saptandı. 15 hastada lenf nodu metastazı mevcuttu. 26 hastada tiroid lobektomisi, yedi hastada total tiroidektomi uygulandı. Sonuç: Kliniğimizde total larenjektomi özellikle T4a larenks tümörlerinde ve yüksek tümör yüküne sahip, akciğer kapasitesi sınırlı seçilmiş T3 supraglottik tümörlerde ve transglottik tümörlerde tercih edilmektedir. Total larenjektomiye eşlik eden tiroidektomi kararının daha seçici kriterlerle verilmesi gerektiği kanaatindeyiz. Anahtar Kelimeler: larenks kanseri; total larenjektomi; tiroidektomi; metastaz

Keywords

• larenks kanseri
• larenjektomi
• tiroidektomi
• metastaz

Supporting Institution

Yok

Ethical Statement

Bu çalışma Adana Şehir Eğitim ve Araştırma Hastanesi Bilimsel Araştırmalar Etik Kurulu tarafından onaylanmıştır (Tarih: 30.03.2026, No:1251) ve 2013 Helsinki Deklarasyonu ile düzenlenmiştir.

References

1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics. CA Cancer J Clin. 2024;74(1):12-49. Crossref
2. Chotipanich A. Total laryngectomy: a review of surgical techniques. Cureus. 2021;13(9):e18181. Crossref
3. Pfister DG, Spencer S, Adelstein D, et al. Head and neck cancers, version 2.2020, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2020;18(7):873-898. Crossref
4. Watkinson JC, Clarke RW. Scott-Brown's Otorhinolaryngology and Head and Neck Surgery. 8th ed. CRC Press; 2018. Crossref
5. Mendelson AA, Al-Khatib TA, Gullane PJ, et al. Thyroid gland management in total laryngectomy. Arch Otolaryngol Head Neck Surg. 2009;135(10):1047-1051. Crossref
6. Gil Z, Fliss DM. Contemporary management of head and neck cancers. In: Head and Neck Surgery. Springer; 2010.
7. Gorphe P, Ben Lakhdar A, Tao Y, et al. Evidence-based management of the thyroid gland during a total laryngectomy. Laryngoscope. 2015;125(10):2317-2322. Crossref
8. Kim JW, Han GS, Byun SS, et al. Thyroid gland invasion in advanced laryngeal carcinoma. Head Neck. 2008;30(6):784-789. Crossref

9. Biel MA, Maisel RH. Complications of thyroidectomy associated with total laryngectomy. Otolaryngol Clin North Am. 1991;24(6):1293-1301.
10. Flint PW, Haughey BH, Lund VJ, et al. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia: Elsevier; 2021.
11. Johnson JT, Rosen CA. Bailey's Head and Neck Surgery: Otolaryngology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2014.
12. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancers. Version 2024.
13. Shah JP, Patel SG, Singh B. Jatin Shah's Head and Neck Surgery and Oncology. 4th ed. Elsevier; 2012.
14. Myers EN, Suen JY. Cancer of the Head and Neck. 4th ed. Saunders; 2003.
15. Yuen APW, Wei WI, Lam LK, Ho WK. Thyroid gland invasion by laryngeal carcinoma. Clin Otolaryngol Allied Sci. 1995;20(6):526-529. Crossref
16. Biel MA, Maisel RH. Indications for thyroid gland removal in advanced laryngeal carcinoma. Arch Otolaryngol Head Neck Surg. 1985;111(8):511-512.