Seçil Kayalı DİNÇ, Tuğba Naciye DOĞAN, Melih ÇAYÖNÜ, Süleyman BOYNUEĞRİ, Zehra Betül PAKSOY, Aydın ACAR, Evrim Ünsal TUNA, Özgür GÜLTEN

Incidence of thyroid gland invasion in locally advanced laryngeal carcinoma

Objectives: This study aims to determine the frequency of thyroid gland invasion in patients with locally advanced laryngealcarcinoma who were treated with total laryngectomy and neck dissection as well as hemi- or total thyroidectomy.Patients and Methods: Between April 2000 and February 2016, 127 patients (123 males, 4 females; mean age 57 years;range, 41 to 74 years) who underwent total laryngectomy and neck dissection with laryngeal squamous cell carcinoma wereretrospectively reviewed in our clinic. Patients’ demographic characteristics, preoperative tumor stage, postoperative laryngectomypathology report, tumor invasion, neck lymph node invasion and thyroid gland invasion were evaluated.Results: In 127 patients, 43 with subglottic extension, extralaryngeal extension and cricothyroid membrane invasion underwent totalor hemithyroidectomy in addition to laryngectomy and neck dissection. Squamous cell carcinoma infiltration was found in one patient(2.3%) in the thyroid gland. This patient was diagnosed as T4N1M0 in the pathological stage. Thyroid cartilage invasion and subglotticextension were detected in the preoperative evaluation.Conclusion: Thyroidectomy is performed in our clinic only when subglottic extension, extralaryngeal invasion or cricothyroidmembrane invasion is present. Hence, thyroid gland invasion is not common in carcinoma of the larynx. For this reason, werecommend selective thyroidectomy to protect patients from the morbidity of routine thyroidectomy.

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1. NCCN clinical practice guidelines in Head and Neck Cancers. Version 2.2017. Available from: https://www. nccn.org/store/login/login.aspx?
2. Kumar R, Drinnan M, Robinson M, Meikle D, Stafford F, Welch A, et al. Thyroid gland invasion in total laryngectomy and total laryngopharyngectomy: a systematic review and meta-analysis of the English literature. Clin Otolaryngol 2013;38:372-8.
3. Elliott MS, Odell EW, Tysome JR, Connor SE, Siddiqui A, Jeannon JP, et al. Role of thyroidectomy in advanced laryngeal and pharyngolaryngeal carcinoma. Otolaryngol Head Neck Surg 2010;142:851-5.
4. Gürbüz MK, Açikalin M, Tasar S, Cakli H, Yorulmaz G, Erdinç M, et al. Clinical effectiveness of thyroidectomy on the management of locally advanced laryngeal cancer. Auris Nasus Larynx 2014;41:69-75.
5. Mendelson AA, Al-Khatib TA, Julien M, Payne RJ, Black MJ, Hier MP. Thyroid gland management in total laryngectomy: meta-analysis and surgical recommendations. Otolaryngol Head Neck Surg 2009;140:298-305.
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.
7. Ho AC, Ho WK, Lam PK, Yuen AP, Wei WI. Thyroid dysfunction in laryngectomees-10 years after treatment. Head Neck 2008;30:336-40.
8. Iype EM, Jagad V, Nochikattil SK, Varghese BT, Sebastian P. Thyroid Gland Involvement in Carcinoma Larynx and Hypopharynx-Predictive Factors and Prognostic Significance. J Clin Diagn Res 2016;10:XC05- XC07.
9. Gorphe P, Ben Lakhdar A, Tao Y, Breuskin I, Janot F, Temam S. Evidence-based management of the thyroid gland during a total laryngectomy. Laryngoscope 2015;125:2317-22.
10. Mourad M, Saman M, Sawhney R, Ducic Y. Management of the thyroid gland during total laryngectomy in patients with laryngeal squamous cell carcinoma. Laryngoscope 2015;125:1835-8.
11. Kim JW, Han GS, Byun SS, Lee DY, Cho BH, Kim YM. Management of thyroid gland invasion in laryngopharyngeal cancer. Auris Nasus Larynx 2008;35:209-12.
12. Ozgursoy OB, Jacobs JR. Necessity of routine ipsilateral hemithyroidectomy during laryngopharyngectomy for pyriform sinus cancer. Am J Otolaryngol 2012;33:562-4.
13. Léon X, Gras JR, Pérez A, Rodríguez J, de Andrés L, Orús C, et al. Hypothyroidism in patients treated with total laryngectomy. A multivariate study. Eur Arch Otorhinolaryngol 2002;259:193-6.
14. Gal RL, Gal TJ, Klotch DW, Cantor AB. Risk factors associated with hypothyroidism after laryngectomy. Otolaryngol Head Neck Surg 2000;123:211-7.