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Objective <p>The aim of our study was to evaluate the incidence of occult laryngeal tumor invasion into the thyroid gland and to determine the role of preoperative clinical parameters in predicting the risk of thyroid gland involvement (TGI).</p> Background <p>Generally, thyroidectomy is recommended for nearly all patients undergoing total laryngectomy (TLE) for the treatment of advanced laryngeal cancer, but the procedure is related to increased post-treatment morbidity.</p> Methods <p>In a retrospective analysis of 61 patients after TLE with thyroidectomy, we monitored the incidence of TGI and its relationship with clinical and histological parameters.</p> Results <p>We identified 8% of patients with TGI. The statistically significant risk parameters for TGI were T4 stage (p=0.023) and full-thickness thyroid cartilage chondrolysis (p=0.044); subglottic tumor growth was nearly significant (p=0.15). Elective thyroidectomy was associated with a lower recurrence rate, both locoregional and distant (6 vs.32).</p> Conclusion <p>Routinely performed elective thyroidectomy during TLE is not necessary because the incidence of occult TGI is low. In the elective setting, hemithyroidectomy is sufficient and should be indicated for T4 and selected T3 tumors in which it brings a prognostic benefit.</p>

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Predictors of Thyroid Gland Invasion in Advanced Laryngeal Carcinoma: When is an Elective Thyroidectomy Indicated?

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月13日

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  • Z. Horakova,
  • J. Zapletalova,
  • R. Salzman

摘要

Objective

The aim of our study was to evaluate the incidence of occult laryngeal tumor invasion into the thyroid gland and to determine the role of preoperative clinical parameters in predicting the risk of thyroid gland involvement (TGI).

Background

Generally, thyroidectomy is recommended for nearly all patients undergoing total laryngectomy (TLE) for the treatment of advanced laryngeal cancer, but the procedure is related to increased post-treatment morbidity.

Methods

In a retrospective analysis of 61 patients after TLE with thyroidectomy, we monitored the incidence of TGI and its relationship with clinical and histological parameters.

Results

We identified 8% of patients with TGI. The statistically significant risk parameters for TGI were T4 stage (p=0.023) and full-thickness thyroid cartilage chondrolysis (p=0.044); subglottic tumor growth was nearly significant (p=0.15). Elective thyroidectomy was associated with a lower recurrence rate, both locoregional and distant (6 vs.32).

Conclusion

Routinely performed elective thyroidectomy during TLE is not necessary because the incidence of occult TGI is low. In the elective setting, hemithyroidectomy is sufficient and should be indicated for T4 and selected T3 tumors in which it brings a prognostic benefit.