Conservative surgical management of invasive differentiated thyroid cancer

1985 ◽  
Vol 99 (12) ◽  
pp. 1255-1260 ◽  
Author(s):  
Y. Shvili ◽  
Y. Zohar ◽  
N. Buller ◽  
N. Laurian
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Surgical Management ◽  
Upper Airway ◽  
Differentiated Thyroid Carcinoma ◽  
Tracheal Resection ◽  
Low Grade ◽  
Tracheal Defect ◽  
Airway Invasion ◽  
Well Differentiated

AbstractThe majority of well differentiated thyroid carcinoma are tumours of low grade malignancy. Laryngotracheal invasion by well differentiated thyroid carcinoma is an uncommon occurrence. The surgical management of patients with thyroid cancer invading the upper airway has primarily been by total laryngectomy. Other surgeons recommend in selected cases partial laryngeal and/or tracheal resection.A total of 122 patients with thyroid carcinoma were treated in our department between 1967 and 1982. Only seven patients with well differentiated tumours had airway invasion. In these seven patients we used a partial laryngeal and/or tracheal resection. In three of the patients with tracheal invasion a myoperichondrial flap was used for closing the tracheal defect. A partial resection of the larynx and trachea, and end to end anastomosis between the trachea and the remaining part of the larynx was performed in another four patients.

scholarly journals The surgical management of locally advanced well-differentiated thyroid carcinoma: changes over the years according to the AJCC 8th edition Cancer Staging Manual

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Alessio Metere ◽  
Valerio Aceti ◽  
Laura Giacomelli
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Surgical Management ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Cancer Staging ◽  
Differentiated Thyroid Carcinoma ◽  
Main Body ◽  
Well Differentiated ◽  
8Th Edition

Abstract Background Well-differentiated thyroid carcinoma is defined as locally advanced in the presence of an extra thyroid extension, e.g., when the surrounding structures such as the trachea, larynx, esophagus and main blood vessels are invaded by cancer. The 8th edition AJCC Cancer Staging Manual states that this is the main characteristic to evaluate for the staging and consequently for the prognosis in patients over 55 years old. Main body Distinguishing different forms of locally advanced thyroid cancer is essential, and the various anatomical structures and the clinical and therapeutic consequences must be taken into account. An accurate diagnosis of the organs invaded by thyroid cancer is necessary for the planning of surgical treatment, and both aspects are crucial to improving the patients’ survival. Patients affected by thyroid cancer with extra thyroid extension have a poor prognosis and the removal of the entire neoplasm represents a key factor for better disease-free survival. Conclusions We discuss the changes introduced by the 8th edition AJCC Cancer Staging Manual, in terms of the diagnostic and surgical management of extra thyroid extension, in patients affected by papillary and follicular thyroid cancer.

Upper airway invasion by well-differentiated thyroid carcinoma

1993 ◽  
Vol 107 (8) ◽  
pp. 752-754 ◽  
Author(s):  
Martin J. Donnelly ◽  
Niall Considine ◽  
Donald P. McShane
Keyword(s):  
Thyroid Carcinoma ◽  
Upper Airway ◽  
Differentiated Thyroid Carcinoma ◽  
Airway Invasion ◽  
Well Differentiated

The Role of Total Laryngectomy in the Management of Intraluminal Upper Airway Invasion by Well-Differentiated Thyroid Carcinoma

1994 ◽  
Vol 73 (9) ◽  
pp. 659-662 ◽  
Author(s):  
Martin J. Donnelly ◽  
Conrad I. Timon ◽  
Donald P. McShane
Keyword(s):  
Thyroid Carcinoma ◽  
Total Laryngectomy ◽  
Upper Airway ◽  
Differentiated Thyroid Carcinoma ◽  
Best Interest ◽  
Laryngeal Function ◽  
Airway Invasion ◽  
Well Differentiated ◽  
Voice Preservation

Intraluminal invasion of the upper airway by well differentiated thyroid carcinoma is very uncommon, and the management can be problematic. Many conservative, reconstructive-type surgical procedures have been advocated to maintain normal laryngeal function. Although voice preservation is desirable, it may not always be in the patient's best interest and radical surgery, including total laryngectomy, may be necessary. We describe three cases in which total laryngectomy was performed, and review the indicators for this procedure in the treatment of this difficult to manage condition.

Laryngotracheal Invasion by Thyroid Carcinoma

1982 ◽  
Vol 91 (4) ◽  
pp. 363-369 ◽  
Author(s):  
Michael Friedman ◽  
Vicki K. Shelton ◽  
Frederick G. Berlinger ◽  
Emanuel M. Skolnik ◽  
Mohammad Arab
Keyword(s):  
Experimental Study ◽  
Thyroid Carcinoma ◽  
Retrospective Analysis ◽  
Total Laryngectomy ◽  
Cricoid Cartilage ◽  
Differentiated Thyroid Carcinoma ◽  
Airway Narrowing ◽  
Airway Invasion ◽  
Well Differentiated ◽  
Laryngotracheal Invasion

Laryngotracheal invasion by well-differentiated thyroid carcinoma is an uncommon occurrence. Recommendations for therapy have primarily included total laryngectomy or shaving of the tumor from laryngeal or tracheal cartilages. Clear guidelines have not been established for the applicability of partial laryngeal resections. In a retrospective analysis of patients with thyroid carcinoma, 13 patients had airway invasion. Of the five patients with laryngeal involvement, three were treated by a partial laryngeal resection. An experimental study was undertaken to determine more precisely the amount of cricoid cartilage which could be resected without reconstruction. Varying amounts of cricoid cartilage were resected. The results indicate that 25% of the cricoid cartilage may be resected without appreciable airway narrowing. On the basis of the retrospective analysis and experimental study, we feel a partial laryngeal resection is possible in most cases of airway invasion by thyroid carcinoma.

scholarly journals Characteristics of thyroid carcinoma in Graves' disease, chronic lymphocitic thyroiditis and nodular goiter

2003 ◽  
Vol 50 (3) ◽  
pp. 135-139
Author(s):  
Aleksandar Filipovic ◽  
Ivan Paunovic
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Nodular Goiter ◽  
Differentiated Thyroid Carcinoma ◽  
Anaplastic Carcinoma ◽  
Graves Disease ◽  
Associated Diseases ◽  
Clinical Centre ◽  
Well Differentiated

The biology of thyroid cancer represents a spectrum of behavior ranging from well - differentiated lesions with an excellent prognosis to anaplastic carcinoma, wich is almost fatal. For this reason, it is important that clinicians have methods at their disposal to asses the characteristics of patient's thyroid malignancy. In this work we discuss the behavior of differentiated thyroid cancer in associated diseases of thyroid as : Graves? disease, chronic lymphocitic thyroiditis - Hashimoto and nodular goiter. This is retrospectively reviewing of 50 patients treated for differentiated thyroid carcinoma at Department of surgery, Clinical Centre of Montenegro in Podgorica from 1998 until 2003. We evaluated occurrence, as well as the role of this diseases in patients with thyroid cancer.We found a more favorable course of thyroid cancer in the presence of chronic lymphocitic thyroiditis and nodular goiter, a contrary Graves? disease. In associated diseases of thyroid, a significantly greater proportion of patients with thyroid cancer, have modular goiter.

scholarly journals Therapeutic Outcomes of Recurrent Well-Differentiated Thyroid Carcinomas

2019 ◽  
Vol 104 (7-8) ◽  
pp. 304-313
Author(s):  
Chih-Yiu Tsai ◽  
Shu-Fu Lin ◽  
Szu-Tah Chen ◽  
Chuen Hsueh ◽  
Yann Sheng Lin ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Recurrent Disease ◽  
Differentiated Thyroid Carcinoma ◽  
Thyroid Carcinomas ◽  
Specific Mortality ◽  
Disease Specific Mortality ◽  
Well Differentiated ◽  
Disease Specific

Objective The aim of this study was to evaluate outcomes of the recurrent and non-recurrent groups including disease-specific mortality of patients with well-differentiated thyroid carcinoma after multimodality treatment. In addition, prognostic factors for disease-specific mortality were analyzed. Summary of Background Data Among 2,844, there were 166 patients with recurrent disease. Recurrent disease was defined as the presence of papillary or follicular thyroid cancer 6 months after the initial thyroidectomy, including locoregional or distant metastasis, diagnosed using diagnostic or therapeutic 131I scans or other imaging techniques. Methods The study was a retrospective analysis of prospectively collected data for a long-term follow-up result of well-differentiated thyroid carcinoma patients. Results The mean age of 166 patients was 45.8 ± 1.2 years, 116 (69.9%) were women, 111 (66.9%) had locoregional neck recurrence, and 55 (33.1%) had metastatic recurrence in distant organs. We found that when recurrences were observed, more than half were detected within the first 5 years following the initial therapy. The longest period of time before relapse was 29.8 years. After a mean follow-up period of 12.7 ± 0.5 years, 37 (22.3%) patients experienced disease-specific mortality. Multivariable analysis revealed that older age, male sex, and development of a second primary malignancy were associated with disease-specific mortality. Higher post-operative levels of thyroglobulin predicted a shorter time to relapse. Conclusions These data indicate that among the recurrent cases over 50% of recurrent well-differentiated thyroid carcinomas were diagnosed within 5 years after initial thyroidectomy. Additionally, more than 20% of the patients died of thyroid cancer.

scholarly journals Genetic Predisposition to Familial Nonmedullary Thyroid Cancer: An Update of Molecular Findings and State-of-the-Art Studies

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Elena Bonora ◽  
Giovanni Tallini ◽  
Giovanni Romeo
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Association Studies ◽  
Disease Onset ◽  
Differentiated Thyroid Carcinoma ◽  
Extended Pedigrees ◽  
Complex Process ◽  
Well Differentiated ◽  
Successive Generations ◽  
High Degree

Familial thyroid cancer has become a well-recognized entity in patients with thyroid cancer originating from follicular cells, that is, nonmedullary thyroid carcinoma. The diagnosis of familial thyroid cancer provides an opportunity for early detection and possible prevention in family members. Understanding the syndromes associated with familial thyroid cancer allows clinicians to evaluate and treat patients for coexisting pathologic conditions. About five percents of patients with well-differentiated thyroid carcinoma have a familial disease. Patients with familial non-medullalry thyroid cancer have more aggressive tumors with increased rates of extrathyroid extension, lymph node metastases, and frequently show the phenomenon of “anticipation” (earlier age at disease onset and increased severity in successive generations). So far, four predisposition loci have been identified in relatively rare extended pedigrees, and association studies have identified multiple predisposing variants for differentiated thyroid cancer. This suggests that there is a high degree of genetic heterogeneity and that the development of this type of tumor is a multifactorial and complex process in which predisposing genetic variants interact with a number of incompletely understood environmental risk factors. Thus, the search for the causative variants is still open and will surely benefit from the new technological approaches that have been developed in recent years.

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