Bronchoscopic Diagnosis of Thyroid Cancer With Laryngotracheal Invasion

Koike, Eisuke; Yamashita, Hiroyuki; Noguchi, Shiro; Yamashita, Hiroto; Ohshima, Akira; Watanabe, Shin; Uchino, Shigehiko; Takatsu, Keisuke; Nishii, Ryuichi

doi:10.1001/archsurg.136.10.1185

Cited by 29 publications

(35 citation statements)

References 26 publications

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“…there are differences in histopathological characteristics and biological behaviors between these three types of thyroid carcinoma, Ptc, Ftc and Mtc and, therefore, their 5-and 10-year survival rates are different [1,4,18]. However, there are no significant differences in 5-and 10-year survival rates between 48 patients in our series.…”

Section: Discussioncontrasting

confidence: 53%

A review of the management and prognosis of thyroid carcinoma with tracheal invasion

Peng

Yang

et al. 2014

Eur Arch Otorhinolaryngol

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The objective of the study was to explore the surgical approaches, treatment significance and prognosis of thyroid carcinoma with tracheal invasion. We retrospectively reviewed 48 patients with tracheal invasion by papillary thyroid carcinoma, follicular thyroid carcinoma and medullary thyroid carcinoma by means of clinical data ranging from 1993 to 2011. The patients were classified into three groups in terms of the depth and extent of tracheal invasion by the tumors, i.e., group A of 18 patients with localized tracheal invasion; group B of 21 patients with intraluminal tracheal invasion, and group C of nine patients with extensive invasion of the trachea, larynx, esophagus and/or mediastinum. Of these patients, 18 received radical tumorectomy and segmental resection of the outer layer of the tracheal wall; 21 had radical tumorectomy, circumferential sleeve trachea resection or segmental tracheal resection plus tracheal repair, and the remaining nine patients underwent radical tumorectomy, segmental trachea resection and esophagolaryngectomy. 46 patients took I(131) oral solution and/or had external radiotherapy postoperatively. A survival analysis was done using Kaplan-Meier Estimator for cumulative survival probability together with Log-Rank test, and Cox Regression Model was used for multivariate analysis. (1) In group A of 18 patients, 10 took I(131)oral solution and 7 received radiotherapy after surgery. The overall 5 and 10-year survival rates were 88.93 and 77.78 %, respectively; (2) In group B of 21 patients, 15 took I(131) oral solution and 7 received radiotherapy after surgery. The overall 5 and 10-year survival rates were 90.47 and 61.87 %, respectively; (3) In group C of 9 patients, 7 received radiotherapy after surgery. The overall 5 and 10-year survival rates were 77.78 and 22.22 %, respectively. Whether they received postsurgical I(131) treatment or radiotherapy, there was a statistical difference between the 5-year survival rates and the 10-year survival rates in all of these three groups (P value in each group is <0.05). In the treatment of thyroid carcinoma with tracheal invasion, radical tumorectomy plus tracheal repair, segmental tracheal resection or circumferential sleeve trachea resection could lengthen the survival time. Radical tumorectomy could enhance the probability of survival of patients with thyroid carcinoma that had extensively invaded the larynx, esophagus and/or mediastinum. Postsurgical I(131) treatment and radiotherapy enhanced the probability of survival.

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Section: Discussioncontrasting

confidence: 53%

A review of the management and prognosis of thyroid carcinoma with tracheal invasion

Peng

Yang

et al. 2014

Eur Arch Otorhinolaryngol

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“…CT, MRI, esophagoscopy, or laryngotracheoscopy are not routinely recommended and are only indicated in case of clinical or ultrasonographic suspicion of invasion of adjacent structures (69,70). The use of iodinated contrast should be avoided; however, when iodinated contrast is necessary to better assess the extent of disease, the therapy with 131 I, when indicated, must be deferred for at least one month (71).…”

Section: What Preoperative Assessment Is Recommended?mentioning

confidence: 99%

Thyroid nodules and differentiated thyroid cancer: update on the Brazilian consensus

Rosário

Ward

Carvalho

et al. 2013

Arq Bras Endocrinol Metab

122

152

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Thyroid nodules are frequent findings, especially when sensitive imaging methods are used. Although thyroid cancer is relatively rare, its incidence is increasing, particularly in terms of small tumors, which have an uncertain clinical relevance. Most patients with differentiated thyroid cancer exhibit satisfactory clinical outcomes when treatment is appropriate, and their mortality rate is similar to that of the overall population. However, relapse occurs in a considerable fraction of these patients, and some patients stop responding to conventional treatment and eventually die from their disease. Therefore, the challenge is how to identify the individuals who require more aggressive disease management while sparing the majority of patients from unnecessary treatments and procedures. We have updated the Brazilian Consensus that was published in 2007, emphasizing the diagnostic and therapeutic advances that the participants, representing several Brazilian university centers, consider most relevant in clinical practice. The formulation of the present guidelines was based on the participants' experience and a review of the relevant literature. Arq Bras Endocrinol Metab. 2013;57(4):240-64 Keywords Thyroid nodules; thyroid cancer; Brazilian consensus; update RESUMO Nódulos tireoidianos são muito frequentes, sobretudo quando se empregam métodos sensí-veis de imagem. Embora o câncer seja proporcionalmente raro, sua incidência vem aumentando, especialmente de tumores pequenos, cuja evolução clínica é incerta. A maioria dos pacientes com carcinoma diferenciado de tireoide evolui bem quando adequadamente tratada, com índices de mortalidade similares à população geral. Por outro lado, um percentual não desprezível apresenta recidivas e alguns eventualmente não respondem às terapias convencionais, evoluindo para óbito. Assim, o desafio é distinguir os pacientes merecedores de condutas mais agressivas e, ao mesmo tempo e não menos importante, poupar a maioria de tratamentos e procedimentos desnecessários. Atualizamos o Consenso Brasileiro publicado em 2007, ressaltando os avanços diagnósticos e terapêuticos que os participantes, de diferentes Centros Universitários do Brasil, consideram mais relevantes para prática clínica. A elaboração dessas diretrizes foi baseada na experiência dos participantes e revisão da literatura pertinente. Arq Bras Endocrinol Metab. 2013;57(4):240-64 Descritores

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“…4,6,9 Depth of invasion may be difficult to assess both pre-operatively (via imaging and direct visualisation with bronchoscopy) and intra-operatively, making delineation between stage II and III disease difficult. 11 For example, a normal bronchoscopy may not exclude cartilage invasion. In addition, although MRI scanning is a reasonably good predictor of cartilage invasion, it lacks the resolution needed to identify the precise depth of invasion.…”

Section: Discussionmentioning

confidence: 99%

Tracheal reconstruction using composite nasal septal graft in patients with invasive thyroid carcinoma

2014

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Bronchoscopic Diagnosis of Thyroid Cancer With Laryngotracheal Invasion

Cited by 29 publications

References 26 publications

A review of the management and prognosis of thyroid carcinoma with tracheal invasion

A review of the management and prognosis of thyroid carcinoma with tracheal invasion

Thyroid nodules and differentiated thyroid cancer: update on the Brazilian consensus

Tracheal reconstruction using composite nasal septal graft in patients with invasive thyroid carcinoma

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