The incident of thyroid gland invasion in carcinoma larynx and hypopharynx อุบัติการณ์การเกิดการลุกลามของมะเร็งไปยังต่อมไทรอยด์ในผู้ป่วยมะเร็งกล่องเสียง และช่องคอส่วนล่าง
Article Sidebar
Main Article Content
Abstract
Introduction : Intraoperative management of thyroid gland in laryngeal and hypopharyngeal cancer is controversial.
Purpose : The object of this study were to determine the incidence of thyroid gland invasion in patients with advanced laryngeal and hypopharyngeal squamous cell carcinoma submitted to total laryngectomy.
Study design : Retrospective chart review
Method : Retrospective case series with chart review, from 1 September 2014 to 31 October 2022 was undertaken in Maharaj Nakhon Si Thammarat Hospital.26 patients who underwent surgery for carcinoma larynx and hypopharynx. Surgical specimens were examined to determine the incident of thyroid gland invasion and radiological assessment was done. The recurrent rate and the survival in patients with and without thyroid gland invasion were also analyzed.
Results : In all 25 patients underwent total laryngectomy (20 cases were treated with primary laryngectomy and 5 cases were treated with salvage laryngectomy). Hemithyroidectomy was performed in 13 patients and the total thyroidectomy was performed in 12 patients. The overall frequency of invasion of the thyroid gland was zero. In spite of thyroid cartilage invasion in 44% of cases were
detected in the preoperative radiological imaging, none case demonstrated microscopic thyroid gland invasion. The result indicated that overall survival rate was 3.50 years and recurrent rate was 3.31 years .There was no significant in overall survival between patients with or without thyroid cartilage invasion by radiographic imaging.
Conclusion : Invasion of thyroid gland by laryngeal and hypopharyngeal cancer is uncommon. Unnecessary thyroidectomy lead to hypothyroidism and hypoparathyroidism. We would like to suggest that thyroid gland need not be removed in all laryngectomy, unless there is advanced disease with thyroid cartilage invasion and gross thyroid gland involvement. This can save the patients from the burnt of unnecessary morbid hypothyroid and hypoparathyroidism.
Keywords : thyroidectomy, total laryngectomy, hypothyroidism
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
ต้นฉบับที่ส่งมาพิจารณายังวารสารหู คอ จมูก และใบหน้า จะต้องไม่อยู่ในการพิจารณาของวารสารอื่น ในขณะเดียวกันต้นฉบับที่จะส่งมาจะผ่านการอ่านโดยผู้ทรงคุณวุฒิ หากมีการวิจารณ์หรือแก้ไขจะส่งกลับไปให้ผู้เขียนตรวจสอบแก้ไขอีกครั้ง ต้นฉบับที่ผ่านการพิจารณาให้ลงตีพิมพ์ถือเป็นสมบัติของวารสารหู คอ จมูกและใบหน้า ไม่อาจนำไปลงตีพิมพ์ที่อื่นโดยไม่ได้รับอนุญาต
ตารางแผนภูมิ รูปภาพ หรือข้อความเกิน 100 คำที่คัดลอกมาจากบทความของผู้อื่น จะต้องมีใบยินยอมจากผู้เขียนหรือผู้ทรงลิขสิทธิ์นั้นๆ และใหร้ะบุกำกับไว้ในเนื้อเรื่องด้วย
References
อ้างอิง
Jiaxuan Xie, et al. Thyroid gland invasion in total laryngectomy: A systematic review and
meta-analysis. Int J Surg.2022 Mar;99:106262.
Brennan JA .,Meyer AD.,Jasen BW. The intraoperative management of the thyroid gland during
laryngectomy. Laryngoscope.1991;101:929-934.
Kumar R,et al.Thyroid gland invasion in total laryngectomy and total laryngopharyngectomy : A
systematic review and meta-analysis of the English literature. Clin Otolaryngo.2013
Oct;38(5):372-8.
Lo Galbo.,Micheau C.,Luboinski B. Squamous cell carcinoma of the upper aerodigestive tract
associated with well- differentiated carcinoma of the thyroid gland. Laryngoscope.1991;101:421-424.
Hadi A. Al-Hakami. The incidence of thyroid gland innovation in advanced laryngeal squamous cell
carcinoma. Braz J Otorhinolaryngeol.2021 Sep-Oct ;87(5):533-537.
Biel M.A. Indications for performing hemithyroidectomy for tumors requiring total laryngectomy.
Am j Surg.1985;150:435-439.
Mourad M. Management of the thyroid gland during total laryngectomy in patients with laryngeal
squamous cell carcinoma. Laryngoscope .2015;125:1835-1838.
Harrison D.F. The pathology and management of subglottic cancer. Ann Otol Rhinol Laryngol.
;80:6-12.
El-Sebai Ali M,et al .Routine thyroidectomy with total laryngectomy: Is it really indicated? A
ramdomized controlled trail. Ann Med Surg (Lond). 2022 Jan 31;74:103309.
Elizabeth Mathew Lyle.,Vijay Jagad santhosh.,Kumar Nochikattil. Thyroid gland involvement in
carcinoma larynx and hypopharynx-predictive factors and prognostic significance. Journal of
clinical & diagnostic research 2016 Feb 1.
Sparano A.,Chernock R.,Laccourreye O. Predictor of thyroid gland invasion in glottic squamous
cell carcinoma. Laryngoscope.2005;115(7):1247-50.
Surenda Singh Baghel. Multiple malignancies in patients with head and neck cancer. Am J
Surg.1965;110:537-541.
Mandelson A.A. Thyroid gland management in total laryngectomy:metaanalysis and surgical
recommendations. Otolaryngol Head Neck Surg.2009;140:298-305.
Patrick Sheahan M.D.F.R.C.S.I. Management of Advanced Laryngeal Cancer. Rambam Maimonides Med
J.2014 Apr;5(2):e0015.