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[Results of tracheal or esophageal resections in invasive thyroid carcinomas]
J C Lifante1, F Mancini, F Mithieux
1Service de chirurgie générale et digestive, hôpital de l'Antiquaille, 1, rue de l'Antiquaille, 69321 Lyon, France.
Study Aim:
The aim of this retrospective study was to report results of 21 tracheal or esophageal resections for invasive thyroid carcinomas.
Patients And Methods:
Between January 1988 and August 2000, 21 patients (mean age: 66 years) had a tracheal (n = 10) or esophageal (n = 11) resection for involvement by an invasive thyroid carcinoma. There were eight undifferentiated carcinomas, 11 papillary, one follicular and one epidermoid carcinomas.
Results:
One patient died from pulmonary embolism during the postoperative period. Complications were: tracheal fistula (n = 2), tracheal stenosis (n = 1), esophageal fistula (n = 2), recurrent nerve palsies (n = 8) and hypoparathyroidism (n = 4). Seven patients presented local recurrence and seven presented distant metastases. Ten patients were alive and ten patients died of their carcinoma. The mean survival in this study was 26 months (21 months for anaplastic carcinomas and 41 months for differentiated carcinomas).
Conclusion:
Differentiated thyroid carcinomas have to benefit from a complete tumoral resection; tracheal or esophageal resection is indicated in case of involvement. Anaplastic carcinomas have a poor prognosis; complete resection is indicated only for selected patients; radiotherapy and chemotherapy are used, because surgery is often impossible.