Thyroid gland invasion in advanced squamous cell carcinoma of the larynx and hypopharynx

Publication date: Available online 7 May 2016
Source:Brazilian Journal of Otorhinolaryngology
Author(s): João Mangussi-Gomes, Fernando Danelon-Leonhardt, Guilherme Figner Moussalem, Nicolas Galat Ahumada, Cleydson Lucena Oliveira, Flávio Carneiro Hojaij
IntroductionSquamous cell carcinoma (SCC) of the larynx and hypopharynx has the potential to invade the thyroid gland. Despite this risk, the proposition of either partial or total thyroidectomy as part of the surgical treatment of all such cases remains controversial.ObjectivesTo evaluate the frequency of invasion of the thyroid gland in patients with advanced laryngeal or hypopharyngeal SCC submitted to total laryngectomy (TL) or pharyngolaryngectomy (TPL) and thyroidectomy; to determine whether clinic-pathological characteristics can predict glandular involvement.MethodsA retrospective case series with chart review, from January 1998 to July 2013, was undertaken in a tertiary care university medical center. An inception cohort of 83 patients with larynx/hypopharynx SCC was considered. All patients had advanced stage disease (clinically T3–T4) and underwent TL or TPL in association with thyroidectomy. Adjuvant therapy was indicated when tumor or neck conditions required. Frequency of thyroid cartilage invasion was calculated; univariate and multivariate analysis of demographic, clinical and pathological characteristics associated with cartilage invasion were performed.ResultsThe overall frequency of invasion of the thyroid gland was 18.1%. Glandular involvement was associated with invasion of the following structures: anterior commissure (OR=5.13; 95% CI 1.07–24.5), subglottis (OR=12.44; 95% CI 1.55–100.00) and cricoid cartilage (OR=15.95; 95% CI 4.23–60.11).ConclusionsInvasion of the thyroid gland is uncommon in the context of laryngopharyngeal SCC. Clinical and pathological features such as invasion of the anterior commissure, subglottis and cricoid cartilage are more associated with glandular invasion.



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