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Circumferential Laryngotracheal Resection in Thyroid Cancer: Experience and Outcome in a Single Center

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Abstract

There is limited experience of laryngotracheal resection in patients with differentiated thyroid carcinoma (DTC). The aim of this study was to report our experience of circumferential laryngotracheal resection in DTC and its long-term outcome. In this retrospective study, 10 patients of locally invasive DTC who underwent circumferential laryngotracheal resection between January 2000 and December 2015 were included. Clinicopathologic profile and follow up was noted. Mean age of the cohort was 50.1 ± 7.8 years (M:F = 1: 2.3). Papillary carcinoma was the commonest pathology (60%) followed by follicular carcinoma (20%), 10% each had Hurthle cell and poorly differentiated thyroid carcinoma. Sixty percent patients presented with recurrent or persistent disease and 20% with distant metastases. Vocal cord palsy was observed in 30%. Fifty percent patients underwent tracheal resection with end to end anastomosis and remaining laryngotracheal resection. Carotid artery resection and anastomosis was performed in one patient. Shin stage IV invasion was observed in 80% and stage III in remaining. There was no perioperative mortality. All patients received adjuvant radioiodine therapy and 40% external beam radiotherapy. Median follow up was 48 months. One patient who earlier had tracheal resection underwent total laryngectomy due to recurrent disease after 24 months. Forty percent patients developed distant metastases during follow-up. Mean survival was 77.8 months (CI = 63.0–92.5). Five-year overall survival was 60% and was significantly high in those without distant metastases (p = 0.006). The outcome of circumferential larygotracheal resections for DTC is excellent in terms of local disease control and long term survival.

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Acknowledgements

A part of this study was presented in 16th Biennial Congress of Asian Association of Endocrine Surgeons (AsAES 2018), March 6-10, 2018, New Delhi-India

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No funding was received from any source.

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Authors and Affiliations

  1. Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India

    Vikram Sharanappa, Raouef Ahmed Bichoo, Anjali Mishra & Saroj Kanta Mishra

  2. Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India

    Prasanta Kumar Pradhan

Authors
  1. Vikram Sharanappa
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  2. Raouef Ahmed Bichoo
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  3. Anjali Mishra
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  4. Prasanta Kumar Pradhan
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  5. Saroj Kanta Mishra
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Contributions

AM, RAB: study conception and design; VS, RAB, AM, PKP, SKM: acquisition of data; VS, RAB, AM, PKP, SKM: analysis and interpretation of data; VS, RAB: drafting of manuscript; VS, RAB, AM, PKP, SKM: critical revision of manuscript.

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Correspondence to Anjali Mishra.

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This is a retrospective review of prospectively kept data.

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Approved by all concerned authorities.

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Data is Institute property and can be provided on specific request.

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The study was approved by the department research committee.

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Sharanappa, V., Bichoo, R.A., Mishra, A. et al. Circumferential Laryngotracheal Resection in Thyroid Cancer: Experience and Outcome in a Single Center. Indian J Otolaryngol Head Neck Surg 74 (Suppl 2), 2629–2635 (2022). https://doi.org/10.1007/s12070-020-02339-1

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  • DOI: https://doi.org/10.1007/s12070-020-02339-1

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