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Locally invasive papillary thyroid carcinoma: 1940-1990
T V McCaffrey1, E J Bergstralh, I D Hay
1Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota 55905.
Head & Neck
|March 1, 1994
Summary
Papillary thyroid carcinoma invasion into the trachea and esophagus significantly impacts patient survival. Complete surgical removal of the tumor may improve outcomes for these invasive cancer cases.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- Well-differentiated thyroid carcinoma rarely invades the upper aerodigestive tract, but such invasion causes significant morbidity.
- Commonly invaded structures include recurrent laryngeal nerves, larynx, pharynx, and esophagus, leading to airway insufficiency, dysphagia, and hemoptysis.
Purpose of the Study:
- To clarify the prognostic significance of papillary thyroid carcinoma invasion into adjacent structures on patient survival.
- To evaluate the impact of specific invasion sites and completeness of resection on survival outcomes.
Main Methods:
- Retrospective evaluation of 262 patients with invasive papillary thyroid carcinoma treated between 1940 and 1990.
- Analysis of invasion sites, completeness of tumor removal, and survival data using Kaplan-Meier curves and Cox proportional hazard models.
Main Results:
- Overall survival rates were 79% at 5 years, 63% at 10 years, and 54% at 15 years.
- Tracheal and esophageal invasion were significant negative prognostic factors for survival.
- Completeness of surgical resection approached statistical significance for improving survival.
Conclusions:
- The specific site of invasion in papillary thyroid carcinoma influences patient survival.
- Complete surgical excision of invasive tumors may lead to improved survival outcomes.