Yonsei Med J.  2015 May;56(3):812-818. 10.3349/ymj.2015.56.3.812.

Predictors of Thyroid Gland Involvement in Hypopharyngeal Squamous Cell Carcinoma

Affiliations
  • 1Department of Otorhinolaryngology, Yonsei Head & Neck Cancer Center, Yonsei University College of Medicine, Seoul, Korea. eunchangmd@yuhs.ac
  • 2Department of Surgery, Yonsei Head & Neck Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Pathology, Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
Decision to perform concurrent ipsilateral thyroidectomy on patients with hypopharyngeal cancer is important, and unnecessary thyroidectomy should be avoided if oncologically feasible. We hypothesized that concurrent ipsilateral thyroidectomy is not routinely required to prevent occult metastasis. This study aimed to determine the prevalence of histological thyroid invasion in patients with hypopharyngeal cancer, and to refine the indications for prophylactic ipsilateral thyroidectomy in patients with hypopharyngeal cancer.
MATERIALS AND METHODS
A retrospective review of the medical records from the Department of Otolaryngology at Yonsei University College of Medicine was conducted from January 1994 to December 2009. A total of 49 patients underwent laryngopharyngectomy with thyroidectomy as a primary treatment of hypopharyngeal cancer.
RESULTS
The incidence of thyroid gland involvement was 10.2%. The most common route of invasion was direct extension through the thyroid cartilage. Thyroid cartilage invasion (p=0.034) was the most significant factor associated with thyroid invasion. Disease-specific survival at 5 years was lower in patients with than without thyroid gland invasion (26.7% vs. 55.2%, respectively; p=0.032). Disease-free survival at 5 years was also lower in patients with than without thyroid gland invasion (20.0% vs. 52.1%, respectively; p=0.024).
CONCLUSION
Ipsilateral thyroidectomy in combination with total laryngopharyngectomy is indicated when invasion of the thyroid cartilage is suspected in patients with hypopharyngeal cancer.

Keyword

Hypopharyngeal cancer; total laryngopharyngectomy; thyroidectomy; thyroid cartilage invasion

MeSH Terms

Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell/epidemiology/pathology/*surgery
Disease-Free Survival
Female
Humans
Hypopharyngeal Neoplasms/epidemiology/pathology/*surgery
Incidence
*Laryngectomy
Male
Middle Aged
Neoplasm Invasiveness
Neoplasms, Second Primary/epidemiology/pathology/surgery
*Pharyngectomy
Predictive Value of Tests
Prevalence
Republic of Korea/epidemiology
Retrospective Studies
Thyroid Gland/*pathology/surgery
Thyroid Neoplasms/epidemiology/*secondary
Thyroidectomy/*methods
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