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Thyroid gland invasion in advanced laryngeal and hypopharyngeal carcinoma

Year 2004, Volume: 13 Issue: 1, 9 - 14, 10.02.2004

Abstract

Objectives: To assess the rate of thyroid gland inva­ sion and the need for thyroidectomy in advanced laryn­ geal and hypopharyngeal carcinomas which require total laryngectomy.Patients and Methods: 129 total laryngectomy with ipsilateral hemithyroidectomy and 14 total laryngopharyn- gectomy with total thyroidectomy were performed for pri- mary squamous celi carcinoma of larynx and hypophar- ynx betvveen 1994-2001 in the ENT Department of Gazi University HospitaL İn the surgical specimens of these 143 patients, the presence of tumor invasion of thyroid cartilage and thyroid gland was evaluated retrospectively according to light microscopic examination.Results: None of the laryngeal carcinoma patients had thyroid gland invasion vvhereas eight 57% hypopha­ ryngeal carcinoma patients had thyroid gland invasion.Tvventy patients 16% had evidence of thyroid carti­ lage invasion in laryngeal carcinoma group. There were only 3 21% cases with thyroid cartilage invasion in hypopharyngeal carcinoma patients.Conclusion: There may be no need for performing thy­ roidectomy in ali total laryngectomy cases. We recommend thyroidectomy during total laryngectomy in laryn­ geal carcinoma cases with subglottic extension and advanced hypopharyngeal tumors. Except for these two conditions, the assessment of extralaryngeal extension and thyroid gland invasion will guide vvhether thyroidectomy should be performed or not.

References

  • Bahadur S, Iyer S, Kacker SK. The thyroid gland in the management of carcinoma of the larynx and laryn- gopharynx. J Laryngol Otol 1985;99:1251-3.
  • Gammert C, Weidenbecher M, Pesch HJ, Thyrolf A. Is the prophylactic hemithyreoidectomy indicated in radical neck dissection? (author’s transl). Laryngol Rhinol Otol (Stuttg) 1978;57:19-21. [Abstract]
  • Palmer BV, Gaggar N, Shaw HJ. Thyroid function after radiotherapy and laryngectomy for carcinoma of the larynx. Head Neck Surg 1981;4:13-5.
  • Shafer RB, Nuttall FQ, Pollak K, Kuisk H. Thyroid function after radiation and surgery for head and neck cancer. Arch Intern Med 1975;135:843-6.
  • Gilbert RW, Cullen RJ, van Nostrand AW, Bryce DP, Harwood AR. Prognostic significance of thyroid gland involvement in laryngeal carcinoma. Arch Otolaryngol Head Neck Surg 1986;112:856-9.
  • Biel MA, Maisel RH. Indications for performing hemithyroidectomy for tumors requiring total laryn- gectomy. Am J Surg 1985;150:435-9.
  • Brennan JA, Meyers AD, Jafek BW. The intraoperative management of the thyroid gland during laryngecto- my. Laryngoscope 1991;101:929-34.
  • Pittam MR, Carter RL. Framework invasion by laryn- geal carcinomas. Head Neck Surg 1982;4:200-8.
  • Sessions DG. Surgical pathology of cancer of the lar- ynx and hypopharynx. Laryngoscope 1976;86:814-39.
  • Fagan JJ, Kaye PV. Management of the thyroid gland with laryngectomy for cT3 glottic carcinomas. Clin Otolaryngol 1997;22:7-12.
  • Harrison DF. Thyroid gland in the management of laryngopharyngeal cancer. Arch Otolaryngol 1973;97:301-2.
  • Hollinshead WH, (editor). The head and neck. In: Anatomy for surgeons. 3rd ed. Philadelphia: Harper & Row; 1982. p. 499-504.
  • Lore JM, (editor). The larynx. In: An atlas of head and neck surgery. 4th ed. Philadelphia: W. B. Saunders; 1988. p. 922.
  • Silver CE, (editor). Atlas of head and neck surgery. 1st ed. Edinburgh: Churchill Livingstone; 1986. p. 208.
  • Lavelle RJ. Thyroid function after radiotherapy and total larynbecomy in the treatment of carcinoma of the larynx. Ann Otol Rhinol Laryngol 1971;80:593-8.
  • Murken RE, Duvall AJ 3rd. Hypothyroidism following combined therapy in carcinoma of the laryngophar- ynx. Laryngoscope 1972;82:1306-14.
  • Buisset E, Leclerc L, Lefebvre JL, Stern J, Ton-Van J, Gosselin P, et al. Hypothyroidism following combined treatment for hypopharyngeal and laryngeal carcino- ma. Am J Surg 1991;162:345-7.
  • Vrabec DP, Heffron TJ. Hypothyroidism following treatment for head and neck cancer. Ann Otol Rhinol Laryngol 1981;90(5 Pt 1):449-53.
  • Smolarz K, Malke G, Voth E, Scheidhauer K, Eckel HE, Jungehulsing M, et al. Hypothyroidism after therapy for larynx and pharynx carcinoma. Thyroid 2000;10:425-9.
  • Sinard RJ, Tobin EJ, Mazzaferri EL, Hodgson SE, Young DC, Kunz AL, et al. Hypothyroidism after treat- ment for nonthyroid head and neck cancer. Arch Otolaryngol Head Neck Surg 2000;126:652-7.
  • Liening DA, Duncan NO, Blakeslee DB, Smith DB. Hypothyroidism following radiotherapy for head and neck cancer. Otolaryngol Head Neck Surg 1990;103:10- 3.
  • Wilson JD, Braunwald E, Isselbacher KJ, Petersdorf RG, Martin JB, Fauci AS, et al, (editors). Diseases of the thyroid. In: Harrison’s principles of internal medicine. 12th ed. New York: McGraw-Hill; 1991. p. 1692-712.
  • Gal RL, Gal TJ, Klotch DW, Cantor AB. Risk factors associated with hypothyroidism after laryngectomy. Otolaryngol Head Neck Surg 2000;123:211-7.
  • Alexander MV, Zajtchuk JT, Henderson RL. Hypothyroidism and wound healing: occurrence after head and neck radiation and surgery. Arch Otolaryngol 1982;108:289-91.
  • Weber RS, Marvel J, Smith P, Hankins P, Wolf P, Goepfert H. Paratracheal lymph node dissection for carcinoma of the larynx, hypopharynx, and cervical esophagus. Otolaryngol Head Neck Surg 1993;108:11-7.
  • Cannon CR. Hypothyroidism in head and neck cancer patients: experimental and clinical observations. Laryngoscope 1994;104(11 Pt 2 Suppl 66):1-21.
  • Dadas B, Uslu B, Cakir B, Ozdogan HC, Calis AB, Turgut S. Intraoperative management of the thyroid gland in laryngeal cancer surgery. J Otolaryngol 2001;30:179-83.
  • Yuen AP, Wei WI, Lam KH, Ho CM. Thyroidectomy during laryngectomy for advanced laryngeal carcino- ma-whole organ section study with long-term func- tional evaluation. Clin Otolaryngol 1995;20:145-9.
  • Buckley JG, MacLennan K. Cancer spread in the lar- ynx: a pathologic basis for conservation surgery. Head Neck 2000;22:265-74.

İleri evre larenks ve hipofarenks karsinomlarında tiroid bez tutulumu

Year 2004, Volume: 13 Issue: 1, 9 - 14, 10.02.2004

Abstract

Amaç: Total larenjektomi gerektiren ileri evre larenksve hipofarenks karsinomlarında tiroid bezi tutulumuoranını ve tiroidektomi gerekliliğini değerlendirmek.Hastalar ve Yöntemler: Gazi Üniversitesi Kulak BurunBoğaz Bölümü’nde 1994-2001 yılları arasında, 129 olguda ileri evre primer larenks karsinomu nedeniyle total larenjektomi ile beraber ipsilateral hemitiroidektomi, 14 olguda primer ileri evre hipofarenks karsinomu nedeniyletotal larengofarenjektomi ile beraber total tiroidektomiuygulandı. Bu 143 olgunun cerrahi spesimenlerinde, tiroit bezi ve tiroid kıkırdak invazyonunun varlığı, ışık mikroskopik inceleme sonuçları göz önünde bulundurularak,retrospektif olarak değerlendirildi.Bulgular: Larengeal karsinom olgularının hiçbirinde tiroid bez invazyonu saptanmazken, 14 hipofarenks karsinomlu olgunun sekizinde %57 tiroid bez tutulumumevcuttu. Larenks karsinomlu grupta 20 olguda %16 ,hipofarenks karsinomlu grupta ise üç olguda %21 tiroid kıkırdak invazyonu olduğu saptandı.Sonuç: Total lerenjektomi uygulanan tüm olgularda tiroidektomi yapmanın gerekli olmadığını, ancak subglottikuzanım gösteren larenks karsinomlarında ve ileri evre hipofarenks tümörlerinde total larenjektomi ile birlikte tiroidektominin gerekli olduğunu düşünmekteyiz. Bu iki durum dışında, cerrahi sırasında tümörün larenks dışı dokulara uzanım gösterdiğinin saptanmasının ve makroskobik olarak tiroid bezi tutulumu izlenmesinin tiroidektomikararını almamızda yol gösterici olacağı kanısındayız

References

  • Bahadur S, Iyer S, Kacker SK. The thyroid gland in the management of carcinoma of the larynx and laryn- gopharynx. J Laryngol Otol 1985;99:1251-3.
  • Gammert C, Weidenbecher M, Pesch HJ, Thyrolf A. Is the prophylactic hemithyreoidectomy indicated in radical neck dissection? (author’s transl). Laryngol Rhinol Otol (Stuttg) 1978;57:19-21. [Abstract]
  • Palmer BV, Gaggar N, Shaw HJ. Thyroid function after radiotherapy and laryngectomy for carcinoma of the larynx. Head Neck Surg 1981;4:13-5.
  • Shafer RB, Nuttall FQ, Pollak K, Kuisk H. Thyroid function after radiation and surgery for head and neck cancer. Arch Intern Med 1975;135:843-6.
  • Gilbert RW, Cullen RJ, van Nostrand AW, Bryce DP, Harwood AR. Prognostic significance of thyroid gland involvement in laryngeal carcinoma. Arch Otolaryngol Head Neck Surg 1986;112:856-9.
  • Biel MA, Maisel RH. Indications for performing hemithyroidectomy for tumors requiring total laryn- gectomy. Am J Surg 1985;150:435-9.
  • Brennan JA, Meyers AD, Jafek BW. The intraoperative management of the thyroid gland during laryngecto- my. Laryngoscope 1991;101:929-34.
  • Pittam MR, Carter RL. Framework invasion by laryn- geal carcinomas. Head Neck Surg 1982;4:200-8.
  • Sessions DG. Surgical pathology of cancer of the lar- ynx and hypopharynx. Laryngoscope 1976;86:814-39.
  • Fagan JJ, Kaye PV. Management of the thyroid gland with laryngectomy for cT3 glottic carcinomas. Clin Otolaryngol 1997;22:7-12.
  • Harrison DF. Thyroid gland in the management of laryngopharyngeal cancer. Arch Otolaryngol 1973;97:301-2.
  • Hollinshead WH, (editor). The head and neck. In: Anatomy for surgeons. 3rd ed. Philadelphia: Harper & Row; 1982. p. 499-504.
  • Lore JM, (editor). The larynx. In: An atlas of head and neck surgery. 4th ed. Philadelphia: W. B. Saunders; 1988. p. 922.
  • Silver CE, (editor). Atlas of head and neck surgery. 1st ed. Edinburgh: Churchill Livingstone; 1986. p. 208.
  • Lavelle RJ. Thyroid function after radiotherapy and total larynbecomy in the treatment of carcinoma of the larynx. Ann Otol Rhinol Laryngol 1971;80:593-8.
  • Murken RE, Duvall AJ 3rd. Hypothyroidism following combined therapy in carcinoma of the laryngophar- ynx. Laryngoscope 1972;82:1306-14.
  • Buisset E, Leclerc L, Lefebvre JL, Stern J, Ton-Van J, Gosselin P, et al. Hypothyroidism following combined treatment for hypopharyngeal and laryngeal carcino- ma. Am J Surg 1991;162:345-7.
  • Vrabec DP, Heffron TJ. Hypothyroidism following treatment for head and neck cancer. Ann Otol Rhinol Laryngol 1981;90(5 Pt 1):449-53.
  • Smolarz K, Malke G, Voth E, Scheidhauer K, Eckel HE, Jungehulsing M, et al. Hypothyroidism after therapy for larynx and pharynx carcinoma. Thyroid 2000;10:425-9.
  • Sinard RJ, Tobin EJ, Mazzaferri EL, Hodgson SE, Young DC, Kunz AL, et al. Hypothyroidism after treat- ment for nonthyroid head and neck cancer. Arch Otolaryngol Head Neck Surg 2000;126:652-7.
  • Liening DA, Duncan NO, Blakeslee DB, Smith DB. Hypothyroidism following radiotherapy for head and neck cancer. Otolaryngol Head Neck Surg 1990;103:10- 3.
  • Wilson JD, Braunwald E, Isselbacher KJ, Petersdorf RG, Martin JB, Fauci AS, et al, (editors). Diseases of the thyroid. In: Harrison’s principles of internal medicine. 12th ed. New York: McGraw-Hill; 1991. p. 1692-712.
  • Gal RL, Gal TJ, Klotch DW, Cantor AB. Risk factors associated with hypothyroidism after laryngectomy. Otolaryngol Head Neck Surg 2000;123:211-7.
  • Alexander MV, Zajtchuk JT, Henderson RL. Hypothyroidism and wound healing: occurrence after head and neck radiation and surgery. Arch Otolaryngol 1982;108:289-91.
  • Weber RS, Marvel J, Smith P, Hankins P, Wolf P, Goepfert H. Paratracheal lymph node dissection for carcinoma of the larynx, hypopharynx, and cervical esophagus. Otolaryngol Head Neck Surg 1993;108:11-7.
  • Cannon CR. Hypothyroidism in head and neck cancer patients: experimental and clinical observations. Laryngoscope 1994;104(11 Pt 2 Suppl 66):1-21.
  • Dadas B, Uslu B, Cakir B, Ozdogan HC, Calis AB, Turgut S. Intraoperative management of the thyroid gland in laryngeal cancer surgery. J Otolaryngol 2001;30:179-83.
  • Yuen AP, Wei WI, Lam KH, Ho CM. Thyroidectomy during laryngectomy for advanced laryngeal carcino- ma-whole organ section study with long-term func- tional evaluation. Clin Otolaryngol 1995;20:145-9.
  • Buckley JG, MacLennan K. Cancer spread in the lar- ynx: a pathologic basis for conservation surgery. Head Neck 2000;22:265-74.
There are 29 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Alper Ceylan This is me

Ahmet Köybaşıoğlu This is me

Metin Yılmaz This is me

Sabri Uslu This is me

Korhan Asal This is me

Erdoğan İnal This is me

Publication Date February 10, 2004
Published in Issue Year 2004 Volume: 13 Issue: 1

Cite

APA Ceylan, A., Köybaşıoğlu, A., Yılmaz, M., Uslu, S., et al. (2004). İleri evre larenks ve hipofarenks karsinomlarında tiroid bez tutulumu. The Turkish Journal of Ear Nose and Throat, 13(1), 9-14.
AMA Ceylan A, Köybaşıoğlu A, Yılmaz M, Uslu S, Asal K, İnal E. İleri evre larenks ve hipofarenks karsinomlarında tiroid bez tutulumu. Tr-ENT. February 2004;13(1):9-14.
Chicago Ceylan, Alper, Ahmet Köybaşıoğlu, Metin Yılmaz, Sabri Uslu, Korhan Asal, and Erdoğan İnal. “İleri Evre Larenks Ve Hipofarenks karsinomlarında Tiroid Bez Tutulumu”. The Turkish Journal of Ear Nose and Throat 13, no. 1 (February 2004): 9-14.
EndNote Ceylan A, Köybaşıoğlu A, Yılmaz M, Uslu S, Asal K, İnal E (February 1, 2004) İleri evre larenks ve hipofarenks karsinomlarında tiroid bez tutulumu. The Turkish Journal of Ear Nose and Throat 13 1 9–14.
IEEE A. Ceylan, A. Köybaşıoğlu, M. Yılmaz, S. Uslu, K. Asal, and E. İnal, “İleri evre larenks ve hipofarenks karsinomlarında tiroid bez tutulumu”, Tr-ENT, vol. 13, no. 1, pp. 9–14, 2004.
ISNAD Ceylan, Alper et al. “İleri Evre Larenks Ve Hipofarenks karsinomlarında Tiroid Bez Tutulumu”. The Turkish Journal of Ear Nose and Throat 13/1 (February 2004), 9-14.
JAMA Ceylan A, Köybaşıoğlu A, Yılmaz M, Uslu S, Asal K, İnal E. İleri evre larenks ve hipofarenks karsinomlarında tiroid bez tutulumu. Tr-ENT. 2004;13:9–14.
MLA Ceylan, Alper et al. “İleri Evre Larenks Ve Hipofarenks karsinomlarında Tiroid Bez Tutulumu”. The Turkish Journal of Ear Nose and Throat, vol. 13, no. 1, 2004, pp. 9-14.
Vancouver Ceylan A, Köybaşıoğlu A, Yılmaz M, Uslu S, Asal K, İnal E. İleri evre larenks ve hipofarenks karsinomlarında tiroid bez tutulumu. Tr-ENT. 2004;13(1):9-14.