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Background. Curative surgery can be accomplished by tracheal resection in patients with thyroid carcinoma invading the trachea; however, there is controversy regarding the extent of the tracheal resection. In this study we investigated by means of histologic examination the mode of tracheal invasion by thyroid carcinoma.
Methods. Twenty-one patients with thyroid carcinoma invading the trachea underwent circumferential sleeve resection of the involved trachea. The extent of invasion of the tracheal wall on the adventitial and mucosal sides was compared on histologic examination.
Results. Three to nine tracheal rings were resected. Assessment of longitudinal spread showed that one to six rings (mean; 3.1 rings) were invaded on the adventitial side but only zero to four rings (mean; 1.9 rings) on the mucosal side, with invasion on the mucosal side never exceeding invasion on the adventitial side. In contrast, examination of circumferential spread showed invasion on the mucosal side exceeding invasion on the adventitial side in five cases.
Conclusions. Our results suggest that when the extent of invasion of the adventitia is considered, carcinoma tissue may be left behind on the mucosal side of the trachea when partial wedge resection is performed and that, whenever feasible, circumferential sleeve resection should be performed in patients with thyroid carcinoma invading the trachea.
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- Papillary carcinoma of the thyroid: a clinical and pathological study of 70 fatal cases.Cancer. 1964; 17: 1035-1044
- Resection of the trachea infiltrated by thyroid carcinoma.Ann Surg. 1982; 195: 496-500
- Clinicopathologic study of thyroid carcinoma infiltrating the trachea.Cancer. 1985; 56: 2843-2848
- Surgical treatment of advanced thyroid carcinoma invading the trachea.J Thorac Cardiovasc Surg. 1991; 102: 717-720
- Thyroid carcinoma with tracheal or esophageal involvement: limited or maximal surgery?.Surgery. 1993; 113: 166-172
- Treatment of locally invasive carcinoma of the thyroid: how radical?.Am J Surg. 1980; 140: 514-517
- Radical operation for thyroid carcinoma invading the trachea.Arch Surg. 1984; 119: 1046-1049
- The management of airway involvement in thyroid tumors.Arch Otolaryngol. 1983; 109: 86-90
- Locally invasive, well-differentiated thyroid cancer: 22 years' experience at Memorial Sloan-Kettering Cancer Center.Am J Surg. 1981; 142: 480-483
- Carcinoma of the thyroid gland invading larynx and trachea.Clin Otolaryngol. 1984; 9: 21-25
- The cartilage shaving procedure for thyroid carcinoma invading the tracheal cartilage: is it an appropriate treatment?.Endocr Surg. 1992; 9: 257-260
- Tracheal and tracheobronchial resections: technique and results in 20 cases.J Thorac Cardiovasc Surg. 1966; 51: 1-13
- Primary tracheal anastomosis after resection of the cricoid cartilage with preservation of recurrent laryngeal nerves.J Thorac Cardiovasc Surg. 1975; 70: 806-816
- Resection of thyroid carcinoma infiltrating the trachea.Thorax. 1978; 33: 378-386
- Resectional management of airway invasion by thyroid carcinoma.Ann Thorac Surg. 1986; 42: 287-298
- Thyroid carcinoma infiltrating the trachea: clinical, histologic, and morphometric analysis.J Surg Oncol. 1990; 44: 78-83
- Surgical treatment of invasion of the upper aerodigestive tract by well-differentiated thyroid carcinoma.Am J Surg. 1987; 154: 363-367
Accepted: July 25, 1994
© 1995 Mosby-Year Book, Inc. Published by Elsevier Inc.