Infiltration of the thyroid in advanced laryngeal cancers: a retrospective analysis

Heyfa Belhadj-Miled; Houas Jihene; Monia Ghammam; Njima Maroua Ben; Omri Malika El; Abir Meherzi; Mouna Bellakhdhar; Wassim El Ghali; El Abed Yosra Hasni; Wassim Kermani; Mohamed Abdelkafi

doi:10.1530/endoabs.99.EP809

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Endocrine Abstracts (2024) 99 EP809 | DOI: 10.1530/endoabs.99.EP809

ECE2024 Eposter Presentations Thyroid (198 abstracts)

Infiltration of the thyroid in advanced laryngeal cancers: a retrospective analysis

Heyfa Belhadj-Miled ¹ , Houas Jihene ¹ , Monia Ghammam ¹ , Maroua Ben Njima ¹ , Malika El Omri ¹ , Abir Meherzi ¹ , Mouna Bellakhdhar ¹ , El Ghali Wassim ² , Yosra Hasni El Abed ³ , Wassim Kermani ¹ & Mohamed Abdelkafi ¹

Err

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¹Farhat Hached Hospital, ENT Department, Sousse, Tunisia; ²Department of Anaesthesia, Sousse, Tunisia; ³Farhat Hached Hospital, Departement of Endocrinology, Sousse, Tunisia

Introduction: Pharyngolaryngeal cancers can invade the thyroid either by direct extension or via the lymphatic or hematogenous pathways. These three types of extension explain the indications for thyroidectomy during pharyngolaryngeal surgery, mainly documented for laryngeal cancers.

Methods: This is a retrospective descriptive cross-sectional study of 46 patients who underwent total laryngectomy (TL) associated with a thyroid procedure at the Department of Otolaryngology (ENT) and Cervicofacial Surgery, Farhat Hached Hospital, Sousse, over a period extending from January 2012 to December 2022.

Results: The mean age of our patients was 59.1 years. The sex ratio was 22. The average consultation time was 10.9 months. Dysphonia was the main symptom, found in all patients. Thyroid surgery associated with laryngectomy was performed in all our patients: loboisthmectomy in 52.2% and total thyroidectomy in 47.8%. Invasion of the thyroid gland by laryngeal carcinoma was identified in 8 patients (17.4%). Invasion was macroscopic, by direct extension of the tumour, in 6 (75%) patients and microscopic in 2 (25%). Comparison between groups of patients with and without thyroid invasion revealed that patients with evidence of glandular invasion had the following characteristics: Higher rates of invasion of the following structures by the primary tumor: Anterior commissure (P= 0.047), subglottis (P= 0.004), cricoid cartilage (P=0.002), thyroid cartilage (P=0.089), piriform sinus (P= 0.052). There were no statistically significant differences between the two groups with regard to gender, age, smoking status, T, N, M staging, tumour size, surgery, histological grade and presence of vascular emboli or peri-nervous sheathing.

Conclusion: Thyroid invasion should not be underestimated in advanced pharyngolaryngeal cancers. Preoperative CT scans are essential for its evaluation. Thyroidectomy should not be performed routinely.