甲状腺癌侵犯在晚期喉癌中的临床病理意义。
Thyroid gland involvement in advanced laryngeal cancer: association with clinical and pathologic characteristics.
机构信息
Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Petach Tikva, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
出版信息
Head Neck. 2012 Nov;34(11):1586-90. doi: 10.1002/hed.21972. Epub 2011 Dec 16.
BACKGROUND
Indications for thyroidectomy during laryngectomy are controversial. We examined whether clinicopathologic features can predict thyroid gland involvement, and the prognostic effect of thyroid gland involvement in patients undergoing total laryngectomy.
METHODS
The study set out to review preoperative assessment, operation findings, pathologic findings, and follow-up data.
RESULTS
Thyroid gland involvement was found in 11 of 53 patients (21%) undergoing total laryngectomy and thyroidectomy. Preoperative work-up failed to predict thyroid gland involvement. Thyroid gland involvement was associated with salvage procedures (p = .025), paratracheal metastases (p = .003), and poor overall survival (hazard ratio = 2.74, p = .008).
CONCLUSIONS
Thyroid gland involvement in patients undergoing total laryngectomy is frequent and is associated with poor prognosis. Preoperative assessment failed to predict thyroid gland involvement. We believe that thyroidectomy should be considered in cases with paratracheal lymphatic spread irrespective of tumor location within the larynx.
背景
喉切除术期间行甲状腺切除术的适应证存在争议。我们研究了临床病理特征是否可以预测甲状腺受累，以及甲状腺受累对行全喉切除术患者的预后影响。
方法
本研究回顾了术前评估、手术发现、病理发现和随访数据。
结果
在 53 例行全喉切除术和甲状腺切除术的患者中，有 11 例（21%）发现甲状腺受累。术前检查未能预测甲状腺受累。甲状腺受累与挽救性手术（p =.025）、气管旁转移（p =.003）和总体生存率差（风险比 = 2.74，p =.008）相关。
结论
在行全喉切除术的患者中，甲状腺受累很常见，且与预后不良相关。术前评估未能预测甲状腺受累。我们认为，无论喉内肿瘤位置如何，只要存在气管旁淋巴扩散，就应考虑行甲状腺切除术。
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