[The management of laryngotracheal invasion by well-differentiated thyroid carcinoma].

OBJECTIVE

To investigate the clinical characteristics and treatment of well-differentiated thyroid carcinoma with laryngotracheal resection.

METHODS

Forty-nine cases of well-differentiated thyroid carcinoma with laryngotracheal invasion were treated by different kinds of surgical modalities including local shaving-off, partial laryngotracheal resection with sternocleidomastoid myoperiosteal flap reconstruction, sleeve tracheal resection, total laryngectomy and incomplete tumor resection. Some patients received postoperative radiotherapy. The follow-up periods were 3-20 years with an average of 8 years.

RESULTS

Twenty-two patients with local invasion were treated with shaving-off procedure, among which fifteen had their lesions removed completely with naked eyes and two relapsed postoperatively. Among the 8 cases with minor residual diseases four cases shoured postoperative relapse. Sixteen patients were treated with sleeve tracheal resection or partial laryngotracheal resection with sternocleidomastoid myoperiosteal flap reconstruction. Two patients were treated with total laryngectomy among which only one relapse was found. The only postoperative complication was intratracheal granuloma formation which was found in three patients. The survival rate of the incomplete resection group was significantly lower than that of patients above mentioned. No local relapse was found in postoperative radiotherapy patients except in the patients of the incomplete resection group.

CONCLUSION

According to the degree of invasion, adequate surgical procedure can obtain both cancer resection and organ preservation. Postoperative radiation may decrease relapse and prolong survival.