[Thyroid cancer with extension to the upper respiratory-digestive tract: therapeutic approach]

Thyroid carcinomas usually have a good prognosis, particularly well-differentiated tumors confined to the gland. An analysis was made of the treatment and prognosis of thyroid neoplasms with invasion of the upper respiratory and digestive tract. Of 211 patients treated at our institution from 1975 to 1994, only 18 had invasion of the upper respiratory and digestive system. All patients were treated surgically. The procedures included total thyroidectomy, laryngectomy, partial esophagectomy, and tracheal resection. The neoplasm recurred locally after complete resection in 33%. Cervical lymph node metastases occurred in 17% and distant metastases in 33%. The 5-year survival rate was 46% for well-differentiated carcinomas. Invasion of the respiratory and digestive tract had negative prognostic significance in the statistical analysis. Locally advanced thyroid neoplasms had a poorer prognosis than those limited to the thyroid gland. However, complete surgical resection of the malignancy was achieved in most patients without functionally mutilating procedures and with satisfactory survival results.