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Ann Otol Rhinol Laryngol. 2016 Feb;125(2):97-104. doi: 10.1177/0003489415599000. Epub 2015 Aug 20.

Tracheal and Crico-Tracheal Resection and Anastomosis for Malignancies Involving the Thyroid Gland and the Airway.

Author information

1
Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy ceceplaza@libero.it.
2
Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy.
3
Department of Otorhinolaryngology-Head and Neck Surgery, University of Genoa, Genoa, Italy.

Abstract

OBJECTIVES:

To evaluate outcomes in different malignancies involving the thyroid and infiltrating the airway submitted to tracheal (TRA) or crico-tracheal resection and anastomosis (CTRA).

METHODS:

Retrospective charts review of 27 patients affected by thyroid malignancies involving the airway treated by TRA/CTRA in a single academic institution. Kaplan-Meier curves were used to evaluate the overall (OS) and disease-specific (DSS) survivals and local (LC) and loco-regional control (LRC). Impact on survival of age, comorbidities, previous radiotherapy, types of TRA/CTRA, Shin's stage (II, III, IV), grading (well vs poorly differentiated), and length of airway resected was calculated by the log-rank test.

RESULTS:

Overall survival and DSS at 3 and 5 years were 82.3% and 71.6%, respectively. Local control and LRC in the entire group were 82.3% at 3 and 5 years. Crico-tracheal resection and anastomosis involving the cricoid arch and plate (type C) and tumor differentiation significantly affected OS and DSS (both P < .001). Type C CTRA and tumor differentiation significantly impacted on LC (P = .002 and P = .009, respectively).

CONCLUSIONS:

Grading and extension of CTRA to the cricoid plate are the most important factors for oncologic outcomes in thyroid malignancies infiltrating the airway. Except for poorly differentiated tumors, TRA/CTRA allows adequate LC even in advanced stage lesions involving the crico-tracheal junction.

KEYWORDS:

airway; anastomosis; cricoid; resection; thyroid cancer; trachea

PMID:
26296930
DOI:
10.1177/0003489415599000
[Indexed for MEDLINE]

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