Endocrine Abstracts

Introduction: Intraoperative management of thyroid gland in laryngeal cancer is controversial. In fact, there is no uniform consensus about the need for thyroid surgery in laryngeal cancer.

Objective: Determine the incidence of thyroid gland invasion in patients undergoing surgery for laryngeal squamous cell carcinoma.

Methods: A retrospective study including 62 cases of laryngeal squamous cell carcinoma who underwent a total laryngectomy. A thyroid surgery was performed in case of a subglottic extension ⩾ 1 cm, an anterior extralaryngeal extension (T4a) or evidence of thyroid gland invasion on CT-scan or intraoperatively.

Results: The mean age of our patients was 59 years, predominantly males (98,4%). Eighteen patients had a subglottic extension ⩾1 cm. The tumor was staged T4a in 14 cases. A loboisthmectomy was performed in 16 cases. A total thyroidectomy was done in 2 cases. On histopathological examination, thyroid extension was found in 2 cases (11.11%). No case of hypoparathyroidism nor hypothyroidism was noted among patients treated with thyroidectomy.

Conclusion: Thyroid gland involvement in laryngeal squamous cell carcinoma is rare (0-30%). Furthermore, hemithyroidectomy causes hypothyroidism in 63% of patients, and if combined with radiotherapy, the incidence goes up to 89% of patients. Therefore, thyroidectomy shouldn’t be performed systematically for patients treated with total laryngectomy. It should be done in case of a locally advanced disease with thyroid cartilage transfixion, a macroscopic thyroid gland invasion and a signific subglottic extension.