Resectional Treatment for Thyroid Cancer With Tracheal Invasion

Yang, Chu‐Wen; Lee, Chen Hsen; Wang, Liang Shun; Huang, Biing Shin; Hsu, Wen Hu; Huang, Ming

doi:10.1001/archsurg.135.6.704

Cited by 48 publications

(43 citation statements)

References 14 publications

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“…There were 64 individual case reports and 96 case series (consisting of more than one case). Of the 96 case series, 17 series contained enough details to extract individual patient data; these 110 patients were analyzed with the individual case reports (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Forty-five case series reported exclusively on tracheal invasion by thyroid cancer (Table S1).…”

Section: Quantity Of Evidencementioning

confidence: 99%

Secondary tracheal tumors: a systematic review

Madariaga¹,

Gaissert²

2018

Ann. Cardiothorac. Surg.

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Background: Secondary tracheal tumors arise from mural invasion by primary tumors in adjacent organs, metastatic lymph nodes or blood-born metastasis from distant sites. This systematic review aims to assess the presentation, management options, and clinical outcomes of these uncommon non-tracheal malignancies.Methods: Electronic searches of the MEDLINE database were performed to identify case series and individual case reports of tracheal invasion by primary non-tracheal tumors or metastatic disease. AllEnglish-language studies with available abstracts or articles containing primary data were included.Results: From 1978 to 2017, a total of 160 case reports or case series identified 2,242 patients with invasion of the trachea by tumors of adjacent organs (n=1,853) or by metastatic lymph nodes or hematogenous spread (n=389). Common primary sites of origin were thyroid, esophagus, and lung, and the most common presentation was metachronous (range of interval: 0 to 564 months) with dyspnea, neck mass, voice change and/or hemoptysis. A majority of patients in case reports (77.9%) and case series (66.0%) underwent resection and the most common reported operation was segmental tracheal resection. Fewer patients underwent bronchoscopic intervention (21.7%) and radiation was used in 32.2% of patients. Complications after bronchoscopic treatment included bleeding, granulation tissue, and retained secretions, while anastomotic leak, unplanned tracheostomy, and new recurrent laryngeal nerve paralysis were observed after surgical resection. The rate of 30-day mortality was low (0.01-1.80%). Median survival was higher in patients with thyroid malignancy and in patients who underwent surgical management. Follow-up time ranged from 0.03 to 183 months. Conclusions:Patients with tracheal invasion by metastatic or primary non-tracheal malignancies should be assessed for symptoms, tumor grade, tumor recurrence and concurrent metastases to decide on optimal surgical, bronchoscopic or noninterventional therapy. Clinical experience suggests that palliative endoscopic intervention for tracheal obstruction by metastasis-bearing lymph nodes is underreported.Keywords: Endotracheal metastasis; secondary tracheal tumors; systematic review Submitted Nov 24, 2017. Accepted for publication Dec 21, 2017Dec 21, . doi: 10.21037/acs.2018 View this article at: http://dx.doi.org/10.21037/acs.2018.02.01 Systematic Review IntroductionSecondary tracheal tumors are defined as tumors in, but not of the trachea and comprise a wide spectrum of tumor histologies and stages. There are no populationbased data for these tumors, and in clinical practice these lesions are probably more common than primary neoplasms. A thoracic surgeon probably encounters tracheal obstruction by metastatic lymph nodes more often than invasion by adjacent primary tumors. Since natural history and prognosis are related to the tumor of origin, their management and prognosis may differ considerably from primary tracheal neoplasms; a correct diagnosis with attribution to the origi...

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Section: Quantity Of Evidencementioning

confidence: 99%

Secondary tracheal tumors: a systematic review

Madariaga¹,

Gaissert²

2018

Ann. Cardiothorac. Surg.

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“…The personal experience gained in tracheal resection and reconstruction in differentiated thyroid carcinomas in our institution is the subject of one of the largest series of publications [2]. In recent years it has become apparent that cartilage shaving is not a sufficient procedure for the treatment of tracheal infiltration [3][4][5]. Limited 'window' resections are persistently reported, although the results are inferior [6].…”

Section: Introductionmentioning

confidence: 99%

Influence of Suture Material and Technique on End-to-End Reconstruction in Tracheal Surgery: An Experimental Study in Sheep

Behrend¹,

Klempnauer²

2001

Eur Surg Res

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Resection and end-to-end anastomosis of the trachea represent the preferred treatment for various benign and malignant diseases involving the trachea. Various studies have reported conflicting results with alternative techniques and suture materials for tracheal anastomosis. Our objective was to evaluate three frequently used techniques concerning stenosis rate and histological reaction in a large-animal species. Tracheal resection of 3 cm and end-to-end anastomosis were performed in 15 sheep with the use of three different techniques. In the first group, an interrupted suture with polyglactin, in the second group an interrupted suture with polydioxanone, and in the last group a continuous suture with polypropylene were used. The animals were killed 1, 2, 4, 8, and 24 weeks postoperatively. The luminal stenosis was determined by means of computerized planimetry. All three techniques appeared to be appropriate for tracheal anastomosis. The luminal stenosis developed within the first 8 weeks after surgery. A cross-sectional area of approximately 40–70% was finally achieved. Differences dependent on the suture material are less important than the technical details of the operation.

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“…Una resección curativa debe ser la meta a menos que los resultados de la resección completa del tumor signifiquen excesiva morbilidad perioperatoria o mortalidad, o cuando la enfermedad metastásica generalizada está presente. La resección radical se indica incluso si el tumor invade la tráquea, en cuyo caso se puede complementar con la reconstrucción de las vías respiratorias 6 . Sin embargo, algunos estudios afirman que no hay diferencia en la supervivencia con técnicas menos radicales, siempre que no haya tumor residual 7 .…”

Section: Discussionunclassified

Carcinoma Papilar De Tiroides: Úlcera Sangrante De Piel

Chisthi¹,

Manju²,

Thomas³

2015

Rev Chil Cir

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thyroid cancer and bleeding skin ulcerBackground: Differentiated thyroid cancer has a good prognosis. If there is local tumor infiltration, the prognosis depends on its complete excision. case report: We report a 67 years old woman with a papillary thyroid cancer and a bleeding skin ulcer. The initial assessment disclosed local tumor infiltration of neck structures and cervical lymph nodes. She was subjected to a radical thyroidectomy, radical neck dissection and dissection of involved structures. She was also treated with radioiodine and levothyroxine and remains asymptomatic after two years of follow up

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Resectional Treatment for Thyroid Cancer With Tracheal Invasion

Cited by 48 publications

References 14 publications

Secondary tracheal tumors: a systematic review

Secondary tracheal tumors: a systematic review

Influence of Suture Material and Technique on End-to-End Reconstruction in Tracheal Surgery: An Experimental Study in Sheep

Carcinoma Papilar De Tiroides: Úlcera Sangrante De Piel

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