Resectional treatment for thyroid cancer with tracheal invasion: A long- term follow-up study

Chih Chieh Yang, Chen Hsen Lee, Liang Shun Wang, Biing Shin Huang, Wen Hu Hsu, Ming Hsiung Huang

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Abstract

Hypothesis: Transmural invasion of the trachea by well-differentiated thyroid carcinomas is a locally advanced disease condition. It frequently causes deaths owing to airway obstruction. We hypothesized that resection of the invaded trachea followed by primary anastomosis provides the opportunity for cure. Design: A retrospective review study of medical records. Settings: The surgical department of a tertiary referral center. Patients: Eight patients with well-differentiated thyroid carcinomas, complicated with tracheal invasion resulting in bleeding and airway obstruction, operated on by tracheal resection and immediate anastomosis, were included. Interventions: All patients received total thyroidectomy and neck lymph node dissection as well as segmental tracheal resection followed by primary reconstruction. Postoperative radioactive sodium iodine I 131 treatment and suppression therapy with thyroxine were applied to all of them. Main Outcome Measure: Postoperative follow-up of serum levels of human thyroglobulin and abnormal radioactive iodine 131I from whole body scan. Results: Seven patients are alive. Of these patients, 5 had no evidence of disease; (3 had no evidence of cancer for more than 10 years' follow-up), 2 had regional lymph node metastasis, and 1 had lung metastases. The remaining patient had anastomotic site recurrence with airway obstruction and needed tracheostomy to relieve stridor. She was lost to follow-up 39 months after undergoing the initial operation. Conclusions: Patients with mucosal invasion of the trachea by well-differentiated thyroid carcinomas should be treated by surgical resection followed by primary reconstruction when technically feasible. This facilitates postoperative care, and it is possible to achieve long-term survival with improvement of the quality of life and possible cures.

Original languageEnglish
Pages (from-to)704-707
Number of pages4
JournalArchives of Surgery
Volume135
Issue number6
Publication statusPublished - Jun 2000
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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    Yang, C. C., Lee, C. H., Wang, L. S., Huang, B. S., Hsu, W. H., & Huang, M. H. (2000). Resectional treatment for thyroid cancer with tracheal invasion: A long- term follow-up study. Archives of Surgery, 135(6), 704-707.