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Erschienen in: Langenbeck's Archives of Surgery 6/2006

01.11.2006 | Current Concepts in Endocrine Surgery

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

verfasst von: Nobuyuki Wada, Hirotaka Nakayama, Yoshihiko Masudo, Nobuyasu Suganuma, Yasushi Rino

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 6/2006

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Abstract

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.
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Metadaten
Titel
Clinical outcome of different modes of resection in papillary thyroid carcinomas with laryngotracheal invasion
verfasst von
Nobuyuki Wada
Hirotaka Nakayama
Yoshihiko Masudo
Nobuyasu Suganuma
Yasushi Rino
Publikationsdatum
01.11.2006
Verlag
Springer-Verlag
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 6/2006
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-006-0106-9

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