Clinical outcome of different modes of resection in papillary thyroid carcinomas with laryngotracheal invasion.

Clinical outcome of different modes of resection in papillary thyroid carcinomas with laryngotracheal invasion. Research Abstract Details 

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Clinical outcome of different modes of resection in papillary thyroid carcinomas with laryngotracheal invasion. Abstract Text:

Nobuyuki Wada,Hirotaka Nakayama,Yoshihiko Masudo,Nobuyasu Suganuma,Yasushi Rino,Nobuyuki Wada,Hirotaka Nakayama,Yoshihiko Masudo,Nobuyasu Suganuma,Yasushi Rino,

AIM: The aim of this study is to evaluate the outcome of different modes of resection in papillary thyroid carcinoma (PTC) with laryngotracheal invasion. MATERIALS AND METHODS: Sixty-four primary PTCs with laryngotracheal invasion between 1964 and 2003 were retrospectively analyzed (17 men and 47 women; mean age, 61.6 years; mean follow-up, 92.3 months). Thirteen curative resections included six pharyngolaryngoesophagectomies, two total laryngectomies, and five circumferential resections (complete surgery). Eighteen patients who were candidates for curative resection refused to undergo complete surgery to avoid functional impairment, especially laryngeal function (incomplete surgery). Thirty-three patients with minimal invasion underwent shave or partial resection (conservative surgery). Clinical outcomes were compared between the three groups. The influence of different types of surgery and invasion was also evaluated by Cox proportional hazard analysis. RESULTS: Three (23.1%) complete, 17 (94.4%) incomplete, and 4 (13.8%) conservative surgery patients died of disease (P < 0.0001). The 10-year disease-specific survival (Kaplan-Meier) in complete, incomplete, and conservative surgery patients were 62.9, 11.1, and 87.7%, respectively (log rank test, P < 0.0001). Incomplete surgery related to worse prognosis [p < 0.0001; hazard ratio (HR), 12.9) than complete or conservative surgery. Tracheal deep invasion (p = 0.0019, HR 7.6) and larynx invasion (p < 0.0001, HR 9.9) related to worse prognosis than minimal invasion. CONCLUSION: Curative resection improves clinical outcomes in PTCs with laryngotracheal invasion. Conservative resection for minimal invasion also can achieve favorable prognosis. The degree of tumor invasion is significantly related to survival.

Clinical outcome of different modes of resection in papillary thyroid carcinomas with laryngotracheal invasion. Publishing Authors By Initials

N Wada,H Nakayama,Y Masudo,N Suganuma,Y Rino,N Wada,H Nakayama,Y Masudo,N Suganuma,Y Rino,

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Clinical outcome of different modes of resection in papillary thyroid carcinomas with laryngotracheal invasion. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Langenbeck's archives of surgery / Deutsche Gesell

VOLUME: 391

Page Numbers: 545-9

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ISSN: 1435-2443

DAY: 17

MONTH: 10

YEAR: 2006

Clinical outcome of different modes of resection in papillary thyroid carcinomas with laryngotracheal invasion. Information

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LANGUAGE: eng

NlmUniqueID: 9808285

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AFFILIATION: Department of General Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku Yokohama, Kanagawa 236-0004, Japan. Wadan523@aol.com

Country: Germany

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MEDLINETA: Langenbecks Arch Surg

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