THYROID GLAND INVOLVEMENT IN CANCER OF THE LARYNX: A FIVE-YEAR MULTICENTER STUDY

Abstract- Intra-operative management of thyroid gland in laryngeal cancer is controversial. To determine the rate of thyroid involvement in patients with laryngeal cancer treated by radical surgical excision, we reviewed the records during 1996-2000 in Imam Khomeini Hospital, Cancer Institute, and Amir Alam Hospital.We studied several factors such as age, gender, and tumor location, presence of thyroid involvement, tumor staging and tumor grading. Thyroid involvement was confirmed by pathologic findings. Two hundred and eighty patients were included in this study. The results showed that only 4.64 % of patients (13 cases of 280) treated by laryngectomy had thyroid involvement. Direct invasion was responsible for thyroid involvement in all cases. It was most prevalent in the sixth decade of life and seen in stages 3 and 4 of laryngeal cancer. Thyroid involvement appeared more in men, and in all cases cancer was squamous cell carcinoma. We recommend limited indications for laryngectomy and thyroid lobotomy, including glottic tumor with subglottic invasion, subglottic tumor, intralaryngeal tumor with transcartilage invasion, tumor of sinus piriformis (in stage 4), glottic and supraglottic tumors stage III or IV, which should be individualized. In suspected cases such as those with abnormal thyroid consistency, the decision should be made during laryngectomy