Locally advanced thyroid carcinoma

Patients with locally advanced thyroid carcinoma were studied to document survival, posttreatment vocal cord function, and dysphagia. A retrospective medical record review collected patient data recorded, including age, gender, and tumor-specific data. The outcome data collected included vocal cord function, presence of a tracheotomy or feeding tube, and the presence or absence of dysphagia. I studied 95 patients with surgically managed thyroid cancer. Forty-three patients had locally invasive disease and/or recurrent disease. During a median follow-up of 5 years, 18% of the patients with invasive cancer died of disease. The patients with completely resected invasive cancers had a significantly better survival rate than did the patients with microscopic residual disease. I conclude that complete resection of invasive disease provides a survival advantage and should be accomplished if speech and swallowing can be preserved. Most patients can obtain local control with minimal morbidity, and they rarely die of local disease.