Joshi P, Nair S, Chaturvedi P, Nair D, Shivakumar T, D'Cruz A K
Department of Head and Neck Surgery, Tata Memorial Hospital, Mumbai, India.
J Laryngol Otol. 2014 Jan;128(1):64-7. doi: 10.1017/S0022215113003277. Epub 2014 Jan 16.
The thyroid gland is removed en bloc during laryngectomy. There are no objective criteria for deciding the extent of thyroid gland resection in primary hypopharyngeal cancer cases. The present study aimed to determine the incidence of thyroid gland involvement in hypopharyngeal cancer and identify the various predictors of this involvement.
This paper reports a retrospective analysis of 358 patients with hypopharyngeal cancer, who underwent total laryngectomy with partial or total pharyngectomy at Tata Memorial Hospital, Mumbai between 2004 and 2010.
The mean age of this population was 61 years. The pyriform sinus was the most common hypopharyngeal subsite involved (in 89 per cent of cases). Most patients underwent hemi-thyroidectomy as part of their surgery. The thyroid gland was involved in only 13 per cent of cases.
Thyroid gland involvement is not common in hypopharyngeal cancer. Cases that involved the post-cricoid area, subglottic extension, extralaryngeal spread or prior tracheostomy were associated with a higher risk of thyroid gland involvement. Ipsilateral thyroidectomy is sufficient in most patients undergoing surgery (laryngectomy with partial or total pharyngectomy) for hypopharyngeal cancers.
在喉切除术期间整块切除甲状腺。对于原发性下咽癌病例，尚无确定甲状腺切除范围的客观标准。本研究旨在确定下咽癌中甲状腺受累的发生率，并确定这种受累的各种预测因素。
本文报告了对358例下咽癌患者的回顾性分析，这些患者于2004年至2010年在孟买塔塔纪念医院接受了全喉切除术及部分或全咽切除术。
该人群的平均年龄为61岁。梨状窝是最常受累的下咽亚部位（89%的病例）。大多数患者在手术中接受了甲状腺半切除术。仅13%的病例甲状腺受累。
甲状腺受累在下咽癌中并不常见。累及环状软骨后区、声门下扩展、喉外扩散或既往气管切开术的病例与甲状腺受累风险较高相关。对于大多数接受下咽癌手术（全喉切除术及部分或全咽切除术）的患者，同侧甲状腺切除术就足够了。
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