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Resection margins and prognosis in locally invasive thyroid cancer
Author(s) -
Hartl Dana M.,
Zago Sophie,
Leboulleux Sophie,
Mirghani Haïtham,
Déandreis Desirée,
Baudin Eric,
Schlumberger Martin
Publication year - 2014
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23406
Subject(s) - medicine , esophagus , thyroid cancer , retrospective cohort study , surgery , thyroid , cancer , larynx , thyroid carcinoma , carcinoma
Background Invasive thyroid cancer is rare, and the extent of surgery controversial. The purpose of this study was to present and evaluate therapeutic prognostic factors. Methods We conducted a retrospective single‐center study of differentiated thyroid carcinoma invading the larynx, trachea, and/or esophagus treated surgically with macroscopic complete resection. Results Forty‐six patients (average age, 57 years; average follow‐up, 4 years) were included. Free margins (R0) were obtained for 22 of 46 (49%) and microscopic residual tumor was present after surgery (R1) for 24 (51%). Ten‐year actuarial local control was 100% for R0 and 75% for R1 ( p = .08). Five‐year local control was lower for recurrent tumors versus inaugurally invasive disease (63% vs 87%; log‐rank p = .011). Five‐year and 10‐year actuarial disease‐specific survival (DSS) was correlated with preoperative distant metastases (100% and 87%, respectively, for M0 vs 68% and 34% for M1; p = .01). Conclusion A trend toward lower local control was observed for R1 versus R0. The morbidity of surgery should be weighed against the prognosis if metastases are present. © 2013 Wiley Periodicals, Inc. Head Neck 36: 1034–1038, 2014