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

Sharanappa, Vikram; Bichoo, Raouef Ahmed; Mishra, Anjali; Pradhan, Prasanta Kumar; Mishra, Saroj Kanta

doi:10.1007/s12070-020-02339-1

Cited by 2 publications

(10 citation statements)

References 25 publications

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“…Overall, 656 patients were included in the current systematic review. Gender of patients treated by (C)TRA was detailed in 18 papers ( 26 , 34 , 35 , 38 , 40 , 41 , 43 , 46 , 50 – 53 , 55 , 57 , 58 , 62 , 64 , 66 ) for a total of 355 patients, of whom 59% were females.…”

Section: Resultsmentioning

confidence: 99%

“…Age of patients was reported in 12 manuscripts ( 26 , 34 , 39 – 41 , 50 – 53 , 57 , 64 , 66 ) for a total of 121 patients, with a mean of 60 years (range, 20-85).…”

Section: Resultsmentioning

confidence: 99%

“…Seventeen manuscripts reported data on (C)TRA for DTC alone ( 3 , 33 , 34 , 38 , 40 , 41 , 43 – 45 , 53 , 58 – 63 , 66 ), while 20 for mixed histologies ( 26 , 35 – 37 , 39 , 42 , 46 – 52 , 54 – 57 , 64 , 65 , 67 ). Overall, the distribution of histopathological types in patients treated by (C)TRA was detailed for 376 of them (59%) and their frequency in descending order was as follows: papillary (79%), follicular (7%), poorly differentiated (5%), medullary (2%), Hürtle cell (2%), anaplastic (1%), follicular variant of papillary cancer (1%), metastasis to the thyroid gland from other organs (1%), and rare histotypes such as thyroid squamous cell carcinoma, giant cell carcinoma, and carcinoma with lymphoepithelioma-like pattern (2% all together) ( 26 , 34 , 35 , 37 – 40 , 42 , 44 – 47 , 49 – 53 , 55 , 57 , 62 , 64 , 66 ).…”

Section: Resultsmentioning

confidence: 99%

“…On the other hand, shaving for TC with deeper airway involvement, where R0 resection cannot be achieved or confirmed by frozen sections of cartilaginous tissues and possible microscopic penetration of the tumor into the airway submucosa via lymphatics piercing the inter-cartilaginous spaces may remain undetected, local failure with dismal outcomes have been reported in the literature (70,71). Moreover, while several series included in this systematic review related to patients treated primarily by (C)TRA reported 5-year survival figures >80% (34,41,44,45,47,48,55,57,58,(62)(63)(64)(65)(66), the complication and mortality rates are considerably higher and survival lower when the procedure is applied as a salvage operation for recurrence after more conservative initial surgery (72,73).…”

Section: Mechanisms Of Airway Invasion and Its Therapeutic Implicationsmentioning

confidence: 99%

“…follows: Shin I in 12 (8%) patients, Shin II in 35 (24%), Shin III in 39 (26%), and Shin IV in 62 (42%).Data on perioperative mortality were provided in 36 articles(3,26,(55)(56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67), for a total of 632 patients. The random effects model pooled risk of postoperative mortality was 2.0% (95% CI, 1.0-4.0%), with low heterogeneity.…”

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confidence: 99%

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Tracheal and Cricotracheal Resection With End-to-End Anastomosis for Locally Advanced Thyroid Cancer: A Systematic Review of the Literature on 656 Patients

et al. 2021

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Airway involvement by advanced thyroid carcinoma (TC) constitutes a negative prognosticator, besides being a critical clinical issue since it represents one of the most frequent causes of death in locally advanced disease. It is generally agreed that, for appropriate laryngo-tracheal patterns of invasion, (crico-)tracheal resection and primary anastomosis [(C)TRA] is the preferred surgical technique in this clinical scenario. However, the results of long-term outcomes of (C)TRA are scarce in the literature, due to the rarity of such cases. The relative paucity of data prompts careful review of the available relevant series in order to critically evaluate this surgical technique from the oncologic and functional points of view. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement on the PubMed, Scopus, and Web of Science databases. English-language surgical series published between January 1985 and August 2021, reporting data on ≥5 patients treated for TC infiltrating the airway by (C)TRA were included. Oncologic outcomes, mortality, complications, and tracheotomy-dependency rates were assessed. Pooled proportion estimates were elaborated for each end-point. Thirty-seven studies were included, encompassing a total of 656 patients. Pooled risk of perioperative mortality was 2.0%. Surgical complications were reported in 27.0% of patients, with uni- or bilateral recurrent laryngeal nerve palsy being the most common. Permanent tracheotomy was required in 4.0% of patients. Oncologic outcomes varied among different series with 5- and 10-year overall survival rates ranging from 61% to 100% and 42.1% to 78.1%, respectively. Five- and 10-year disease specific survival rates ranged from 75.8% to 90% and 54.5% to 62.9%, respectively. Therefore, locally advanced TC with airway invasion treated with (C)TRA provides acceptable oncologic outcomes associated with a low permanent tracheotomy rate. The reported incidence of complications, however, indicates the need for judicious patient selection, meticulous surgical technique, and careful postoperative management.

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Section: Resultsmentioning

confidence: 99%

“…Age of patients was reported in 12 manuscripts ( 26 , 34 , 39 – 41 , 50 – 53 , 57 , 64 , 66 ) for a total of 121 patients, with a mean of 60 years (range, 20-85).…”

Section: Resultsmentioning

confidence: 99%