Thyroid Gland in the Management of Laryngopharyngeal Cancer

Harrison, D. F. N.

doi:10.1001/archotol.1973.00780010311001

Cited by 46 publications

(46 citation statements)

References 5 publications

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“…Thyroid dysfunction is a well-recognised complication of curative radiotherapy for laryngeal cancer with reported rates up to 57% [1,2] . The thyroid gland, however, may also show an insidious onset of damage which can go undetected for long periods of time and potentially lead to signiWcant consequences for the patient.…”

Section: Introductionmentioning

confidence: 99%

The incidence of thyroid dysfunction following radiotherapy for early stage carcinoma of the larynx

Kumar

Moorthy

Dhanasekar

et al. 2011

Eur Arch Otorhinolaryngol

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External beam radiotherapy is currently the commonest form of treatment for early laryngeal cancer (T1/2) and thyroid dysfunction is a well recognised complication of this treatment. Overt hypothyroidism is a specific clinical disorder which in most patients will be recognized and treated. The problems associated with subclinical hypothyroidism (elevated TSH with normal T4), however, are only now being recognized and their management is to some extent still controversial. The aims of our study are to determine the incidence of clinical and subclinical hypothyroidism in those who have been treated solely with curative radiotherapy for early laryngeal cancer. We performed a retrospective observational study encompassing all patients who underwent curative radiotherapy for T1/T2 laryngeal cancer between 1998 and 2002. 33 patients were identified (mean 66.85 years, range 48-93). 19 patients had T1 lesions (58%), 14 had T2 lesions (42%) and 27 were N0 (82%). 23 patients were euthyroid post treatment (70%), 2 became overtly hypothyroid (6%) and 8 developed subclinical hypothyroidism (24%). There was no association between tumour stage (p = 0.97), nodal stage (p = 0.46) and thyroid status, however, there was an association between increasing age and deteriorating thyroid function (p = 0.01). Our study showed that of patients with early laryngeal cancers treated solely with curative radiotherapy 24% developed subclinical hypothyroidism and 6% were overtly hypothyroid (Elevated TSH and reduced T4). We feel patients should receive regular thyroid function testing following completion of treatment and should be adequately counselled on the risk of thyroid dysfunction following radiotherapy at pre-treatment visits.

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Section: Introductionmentioning

confidence: 99%

The incidence of thyroid dysfunction following radiotherapy for early stage carcinoma of the larynx

Kumar

Moorthy

Dhanasekar

et al. 2011

Eur Arch Otorhinolaryngol

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“…3,6 One of the main reasons for treatment failure has been attributed to, inadequate level 6 clearance in subglottic extension cases. 10,11 Extralaryngeal spread via thyroid cartilage is directly proportional to the calcification status of the thyroid cartilage. 12,16 The incidence of hypothyroidism in treated advanced head and neck cancer patients is approximately 6-15% when radiotherapy alone.…”

Section: Discussionmentioning

confidence: 99%

Hypothyroidism in surgically treated T4 hypopharyngeal and laryngeal cancers

Janardhan

Varghese

Iype

et al. 2017

Int J Otorhinolaryngol Head Neck Surg

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Background: Total laryngectomy in laryngohypopharyngeal cancers, both in primary setting and salvage scenario, include variable amounts of thyroid resection. Although considerable proportion of these cases undergo total thyroidectomy, with an intention of wider surgical clearance, histopathological examination for thyroid infiltration, very often indicate that such resections are generally out of proportion to the actual oncological requirement.Methods: Forty three patients undergoing total laryngectomy with no prior thyroid dysfunction, from April 2014 to 2016, at our centre, were prospectively studied for post treatment, thyroid function with tests done at 6th month. Overt and occult hypothyroidism was correlated with extent of thyroid preserved intraoperatively. Results: Of 43 patients studied, 82% had extralaryngeal spread, and 16% of them showed thyroid gland infiltration. Only 7% were patholog1ically correlated for gland infiltration. Among those who had hemithyroidectomy, clinical hypothyroidism was seen in 20% primary and 85% salvage cases by 6th month of post treatment period.Conclusions: In clinicoradiologically favourable scenarios, thyroid preservation attempt helps to augment the neopharynx closure line and to preserve the parathyroids. Anatomical preservation however doesnot guarantee thyroid function, which needs regular follow up to avoid post-operative complications and better QOL.

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“…Patients with T3 and T4 squamous carcinomas are usually treated with total laryngectomy, followed by radiotherapy (from 50 to 65 Gy). Removal of a lobe or the whole thyroid gland is indicated, considering the propensity of this tumor to invade the thyroid gland [15,16]. Neck dissection should include pretracheal, paratracheal, prelaryngeal or precricoid (Delphian) nodes, recurrent lymph nodes, lower and middle jugular nodes, and supraclavicular nodes.…”

Section: Treatmentmentioning

confidence: 99%

The pathology and management of subglottic cancer

Ferlito¹,

Rinaldo²

2000

European Archives of Oto-Rhino-Laryngology

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Because there is still considerable controversy concerning the anatomical boundaries separating the three regions of the larynx, cancer of the subglottis remains difficult to manage. We have reviewed the numerous differences in the anatomical definitions used in the literature and the consequent differences in reported findings on the incidence of subglottic cancer and its classification. We have also summarized the pathology of subglottic malignant neoplastic lesions, their presenting symptoms and tendency for spread, and the use of imaging methods in its diagnosis. Suitable forms of treatment are discussed, as are considerations on prognosis.

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Thyroid Gland in the Management of Laryngopharyngeal Cancer

Cited by 46 publications

References 5 publications

The incidence of thyroid dysfunction following radiotherapy for early stage carcinoma of the larynx

The incidence of thyroid dysfunction following radiotherapy for early stage carcinoma of the larynx

Hypothyroidism in surgically treated T4 hypopharyngeal and laryngeal cancers

The pathology and management of subglottic cancer

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