Evidence‐based management of the thyroid gland during a total laryngectomy

Gorphe, Philippe; Lakhdar, Aïcha Ben; Tao, Yungan; Breuskin, Ingrid; Janot, F.; Temam, Stéphane

doi:10.1002/lary.25417

Cited by 23 publications

(27 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This ambispective review of 10 years of consecutive patients treated for squamous cell carcinoma with total laryngectomy at a single center has shown that preoperative CT is an effective method of ruling out thyroid gland invasion. The 11.29% incidence for thyroid invasion described in this study is similar to that reported in larger series; Kumar et al's large meta‐analysis reported 10.7% (95% CI: 7.6%‐14.2%) …”

Section: Discussionsupporting

confidence: 88%

“…Cartilage involvement has not been shown to be predictive of thyroid invasion, as described in other studies . However, extralaryngeal spread on CT has been shown to have a high negative predictive value and specificity, with narrow 95% CIs.…”

Section: Discussionmentioning

confidence: 63%

“…This is the first article to explore this specific question. Gorphe et al showed a statistically significant correlation for thyroid invasion between a preoperative CT and histology, but did not evaluate CT as a test as in this article. Gaillardin et al also showed a statistically significant correlation between CT findings and thyroid invasion, but focused on either cricoid cartilage invasion or thyroid invasion as an outcome.…”

Section: Discussionmentioning

confidence: 80%

“…Several recent articles have sought to improve the evidence behind the decision to remove the thyroid during laryngectomy. The main route of spread of malignancy from the larynx to the thyroid appears to be direct invasion through the cartilage or adjoining membranes, rather than hematogenous or lymphatic . It has been shown that involvement of the subglottis carries a significantly higher risk of thyroid invasion .…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

How reliably can computed tomography predict thyroid invasion prior to laryngectomy?

2017

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

How reliably can computed tomography predict thyroid invasion prior to laryngectomy?

2017

View full text Add to dashboard Cite

show abstract

“…Previous studies have demonstrated that thyroid cartilage involvement and subglottic extension are associated with tumour extension into the thyroid. 17,18 A systematic review and meta-analysis from Newcastle upon Tyne Hospitals highlighted that the relative risk of thyroid gland invasion for patients with subglottic extension was 4.3 (95 per cent CI = 2.5–7.2). 19 While our study confirms the significance of cartilage invasion, the positive predictive value remained low (less than 30 per cent), even for statistically significant associations.…”

Section: Discussionmentioning

confidence: 99%

Management of the thyroid gland during laryngectomy

Polacco

Gosselin

et al. 2017

J. Laryngol. Otol.

View full text Add to dashboard Cite

Objectives This study aimed to: describe the incidence of thyroid gland involvement in advanced laryngeal cancer, analyse patterns of spread to the thyroid and elucidate predictors of thyroid involvement. Methods A retrospective review was performed on patients who underwent laryngectomy from 1991 to 2015 as a primary or salvage treatment for squamous cell carcinoma of the larynx, hypopharynx or base of tongue. The incidence of thyroidectomy during total laryngectomy, type of thyroidectomy, incidence of gland involvement, route of spread, and positive predictors of spread were analysed and reported. Results A total of 188 patients fit the inclusion criteria. Of these, 125 (66 per cent) underwent thyroidectomy. The thyroid was involved in 10 of the 125 patients (8 per cent), 9 by direct extension and 1 by metastasis. Cartilage invasion was a predictor of thyroid gland involvement, with a positive predictive value of 26 per cent. Conclusion There is a low incidence of thyroid gland involvement in laryngeal carcinoma. Most cases of gland involvement occurred by direct extension. Thyroidectomy during laryngectomy should be considered for advanced stage tumours with cartilage invasion.

show abstract

Prognosis of subglottic carcinoma: Is it really worse?

et al. 2018

View full text Add to dashboard Cite

It is traditionally accepted that subglottic carcinoma has a worse prognosis than tumors arising in other subsites of the larynx, owing to its tendency to present in advanced stages, with a high incidence of cartilage invasion and extralaryngeal spread. The incidence of subglottic carcinoma varies among series, mainly because there is no uniform definition of the upper boundary of the subglottis. The extent of the tumor may be difficult to define because subglottic carcinoma may spread through the submucosa without visible mucosal changes. There is also a rich lymphatic network in the subglottis draining to the prelaryngeal and paratracheal lymph nodes, which are usually not involved by cancers arising in other laryngeal subsites. Current literature data indicates that early-stage subglottic carcinoma can be treated using radiotherapy or chemoradiotherapy with high locoregional control and survival rates. In advanced stage subglottic carcinoma, combination of surgery followed by radiotherapy or chemoradiotherapy resulted in comparable outcomes, as in advanced carcinomas from the rest of the larynx. Stage for stage, it is likely that the prognosis for subglottic carcinoma and of glottic and supraglottic cancers is similar.

show abstract

Evidence‐based management of the thyroid gland during a total laryngectomy

Abstract: 4

Cited by 23 publications

References 26 publications

How reliably can computed tomography predict thyroid invasion prior to laryngectomy?

How reliably can computed tomography predict thyroid invasion prior to laryngectomy?

Management of the thyroid gland during laryngectomy

Prognosis of subglottic carcinoma: Is it really worse?

Contact Info

Product

Resources

About