Treatment of Well-differentiated Thyroid Carcinoma with Aerodigestive Tract Invasion

Hah, Jeong Hun; Jung, Eun jung; Roh, Dong Hwan; Kwon, Seong Keun; Sung, Myung Whun; Kim, Kwang Hyun

Abstract

PURPOSE
Well differentiated thyroid carcinomas are mostly curable diseases. Invasion of aerodigestive tract by thyroid carcinoma is rare. However, it is considered as a poor prognostic indicator of survival. Some studies showed that local invasion of thyroid carcinoma was the cause of death in many patients. Therefore, adequate local control of the tumor is critical to avoid the mortality as well as the morbidity of the disease. To find proper and adequate treatment modality of locally invasive thyroid carcinoma, we evaluated treatment modalities and outcomes in the patients with thyroid carcinoma with invasion of aerodigestive tract.
METHODS
Forty patients with thyroid carcinoma invading aerodigestive tract who were treated from July 1989 through July 2002 were reviewed retrospectively.
RESULTS
Direct intraluminal invasion of the thyroid carcinoma requires definitive resection of the aerodigestive tract. In case that the extent of tumor was thought to be limited to perichondrium or extraluminal invasion, tracheal shaving procedure was performed. Five-year and 10-year local control rates were 81.6% and 57.4%, respectively. Disease-specific survival rates of 5-year and 10-year were 90.1% and 81.1%, respectively.
CONCLUSION
For the successful treatment of invasive thyroid carcinoma, the resection of the functional structures or the aerodigestive tract should be determined prudently according to the presence of the intraluminal invasion.