Hypothyroidism after primary surgical treatment for laryngeal and hypopharyngeal cancer

Yıl 2008, Cilt: 18 Sayı: 3, 125 - 130, 25.06.2008

Özlem Kaya Turgut Levent Erişen Hamdi Hakan Coşkun Oğuz Basut Selçuk Onart İbrahim Hızalan

Öz

Objectives: We investigated the incidence of hypothyroidism after treatment of laryngeal or hypopharyngeal cancer LHC , and evaluated its relationship with treatment modalities. Patients and Methods: Thyroid functions of 42 patients 41 males, 1 female; mean age 58 years; range 35 to 81 years undergoing surgical treatment with 74% or without adjuvant radiotherapy for LHC were prospectively evaluated preoperatively, on the 15th day, and in the sixth month postoperatively. The results were compared in relation to the treatment methods employed. Results: The overall incidence of post-treatment hypothyroidism was 23.8%. Five patients had hypothyroidism in the early postoperative period, and this number increased to 10 after six months. All patients with hypothyroidism had undergone total laryngectomy with bilateral neck dissection, followed by radiotherapy. A significantly higher incidence of hypothyroidism was associated with total laryngectomy, bilateral neck dissection, level VI dissection, partial or bilateral thyroidectomy, adjuvant radiotherapy, and upper mediastinal radiothrapy. Conclusion: The incidence of post-treatment hypothyroidism is not rare in LHC patients, requiring long-term monitoring of thyroid functions to prevent associated morbidities.

Anahtar Kelimeler

Hypothyroidism/etiology, laryngeal neoplasms/ surgery, laryngectomy, postoperative complications/etiology, risk factors, thyroid function tests

Larenks ve hipofarenks kanserlerinde primer cerrahi tedavi sonrası hipotiroidizm

Öz

Amaç: Larenks ve hipofarenks kanserlerinde LHK tedavi sonrası hipotiroidi görülme sıklığı araştırıldı ve uygulanan tedavi yöntemi ile hipotiroidi sıklığı arasındaki ilişki incelendi.Hastalar ve Yöntemler: Cerrahi tedavi gören LHK’li 42 hastanın tiroid fonksiyonları ileriye dönük olarak, tedavi öncesinde, ameliyattan 15 gün ve altı ay sonra değerlendirildi. Hastaların %74’üne cerrahiden sonra adjuvan radyoterapi uygulandı. Sonuçlar uygulanan tedavi yöntemleriyle karşılaştırmalı olarak değerlendirildi.Bulgular: Tedavi sonrası genel hipotiroidi oranı %23.8 bulundu. Ameliyat sonrası erken dönemde beş hastada hipotiroidi görülürken, altı ay sonra bu sayı 10’a yükseldi. Hipotiroidi gelişen tüm hastalarda total larenjektomi, iki taraflı boyun diseksiyonu ve ameliyat sonrası radyoterapi uygulanmıştı. Total larenjektomi, iki taraflı boyun diseksiyonu, seviye VI diseksiyon, kısmi veya iki taraflı tiroidektomi, adjuvan radyoterapi ve üst mediastinal radyoterapi uygulamalarının hipotiroidi gelişme sıklığı ile anlamlı ilişki gösterdiği saptandı.Sonuç: Tedavisi sonrası hipotiroidi sıklığı LHK’li hastalarda yüksektir. Hipotiroidi morbiditesinden korunmak için, bu hastalar tiroid fonksiyon testleri ile tedavi sonrasında uzun süreli olarak izlenmelidir

Anahtar Kelimeler

Hipotiroidizm/etyoloji, larenks neoplazileri/cerrahi, larenjektomi, ameliyat sonrası komplikasyon, risk faktörü, tiroid fonksiyon testleri

Kaynakça

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