• International journal of thyroidology
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• v.11 no.2
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• pp.99-108
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• 2018

Most thyroid cancers are well-differentiated cancers and have a very good prognosis. About 10% of thyroid cancer, however, invades the surrounding tissues, causing local recurrence and distant metastasis, and eventually affecting survival rate. In locally advanced thyroid cancers, the invasion of trachea, larynx and esophagus, can be occurred by primary tumor and may also result in lymph nodes metastasis. Surgical resection is still mainstay for the treatment of locally advanced thyroid cancer. The main purpose of the surgical resection is to eliminate the cancer completely, therefore, it can cause many complications such as dysfunction of the larynx, trachea and esophagus. It can have a serious effect on the quality of life, therefore there is still controversy on the extent of the surgery. The authors compare and analyze the opinions which were already discussed in the literatures published so far. These will help to select the surgical method.

• Journal of Chest Surgery
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• v.28 no.12
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• pp.1155-1159
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• 1995

Differentiated thyroid carcinoma is a slow growing tumor with relative good prognosis. But locally advanced thyroid cancer with T4 or N1b is difficult to manage. Between June 1988 and April 1995, we resected 8 advanced thyroid cancers trans-sternally. All patients had direct mediastinal extension [T4 or mediastinal lymph node metastasis [N1b with airway obstruction or dysphagia. We operated all the patients by partial or total sternotomy for mediastinal dissection along with thyroidectomy and radical neck dissection. There were some acceptable morbidities but no operative mortality. Postoperative radioactive iodine therapy was followed without side effects. Follow-up survival period was between 11 months to 81 months with 2 late mortalities [17 month, 30 month . Although definite benefit for routine mediastinal dissection in thyroid cancer has not been established, in locally advanced cases impending airway obstruction or dysphagia who have questionable effect by radioactive iodine therapy alone, aggressive mediastinal mass dissection including lymph node metastasis has the significant role to prevent the patients from suffocation & dysphagia, and to enhance the effect of followed radioactive iodine tharapy.

• 대한두경부종양학회:학술대회논문집
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• 2004.05a
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• pp.94-96
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• 2004

• Korean Journal of Bronchoesophagology
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• v.8 no.1
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• pp.11-16
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• 2002

• Korean Journal of Bronchoesophagology
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• v.7 no.1
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• pp.66-70
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• 2001

Supracricoid partial laryngectomy (SCPL) has been performed in selected patients with transglottic carcinoma of larynx who are not amenable to classically conservative Partial laryngectomy. We have applied this procedure for the complete removal of carcinoma and the satisfactory recovery of function in 74 supraglottic laryngeal cancer Patient with thyroid cartilage invasion. The 65-year-old man with supraglottic squamous carcinoma with thyroid cartilage invasion (74 stage) was treated by SCPL with bilateral lateral neck dissection. The part of larynx and whole thyroid cartilage with tumor invasion was completely removed with covering thyrohyoid muscle and fascia. External perichondrium of the thyroid cartilage containing carcinoma was not exposed from the overlying muscle and fascia on postoperative pathological examination. We confirmed the invasion of thyroid cartilage histopathologically. Tumor was confined in the specimen and the safety margin was proved in all direction. Postoperative course and functional results were uneventful. SCPL can be applied in selected cases of locally advanced 74 laryngeal cancer.

• Radiation Oncology Journal
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• v.28 no.2
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• pp.64-70
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• 2010

Purpose: The aim of the present study was to retrospectively evaluate the incidence of hypothyroidism in locally advanced head and neck cancer patients who received radiotherapy (RT) either with or without neck dissection. Materials and Methods: From January 2000 to December 2005, 115 patients with locally advanced head and neck cancer and who received definitive RT or postoperative RT including standard anterior low-neck field were recruited to be part of this study. Nineteen patients had undergone ipsilateral neck dissection, whereas, 18 patients underwent bilateral neck dissection, and 78 patients were received RT alone. Patients' ages ranged from 28 to 85 years (median, 59 years) and there were a total of 73 male and 42 female patients. The primary tumor sites were the oral cavity, oropharynx, hypopharynx, larynx, and other sites in 18, 40, 28, 22 and 7 patients, respectively. Radiation dose to the thyroid gland ranged from 44 Gy to 66 Gy with a median dose of 50 Gy. Follow-up time ranged from 2 to 91 months, with a median of 29 months. Results: The 1- and 3- year incidence of hypothyroidism was 28.7% (33 patients) and 33.0% (38 patients), respectively. The median time to detection of hypothyroidism was 8.5 months (range, 0 to 36 months). A univariate analysis revealed that neck node dissection was a risk factor for hypothyroidism (p=0.037). However, no factor was statistically significant from the results of a multivariate analysis. Conclusion: Patients treated for advanced head and neck cancer with radiotherapy with or without neck dissection will develop hypothyroidism. It is important to check the thyroid function periodically in these patientsespecially with the risk factor of neck node dissection.

• Radiation Oncology Journal
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• v.17 no.3
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• pp.187-194
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• 1999

Purpose : The aim of this study is to look for the possible efficacy of external irradiation for locally advanced papillary thyroid cancers (stage pT4 or Nl ). Methods and Materials : From August 1981 through September 1997, 91 Patients with locally advanced papillary thyroid cancers (stage pT4 or Nl ) have been treated with external irradiation and followed up at our clinic. All of the patients have been treated with surgical resection. After surgery, 23 patients received postoperative external irradiation with or without ablative radioiodine therapy, whereas the other 68 patients were treated with ablative radioiodine therapy alone. Distributions of sex, age, and stage were comparable in both irradiated and nonirradiated groups. Multivariate analysis of the influence by age, sex, stage, ablative radioiodine therapy and external irradiation on local control were peformed by using Cox's proportional hazard model. Results : Overall survival rates at 7 years were of no significant difference in both groups. There were $98.1\%$ for no RT group and $90\%$ for RT group (p=0.506). 5-year local control rates were significantly different, these were $95.2\%$ for RT group and $67.5\%$ for no RT group (p=0.0408). An analysis of the prognostic factors, age, sex, stage, and RAI were not significant variables, except for the external irradiation. Conclusion : Adjuvant postoperative external irradiation did not affect overall survival, but significantly improved local control in the patients with locally advanced papillary thyroid cancers (stage pT4 or lympy node involvement).

• Radiation Oncology Journal
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• v.35 no.2
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• pp.112-120
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• 2017

Purpose: To evaluate the effect of adjuvant external beam radiation therapy (EBRT) on local failure-free survival rate (LFFS) for papillary thyroid cancer (PTC) invading the trachea. Materials and Methods: Fifty-six patients with locally advanced PTC invading the trachea were treated with surgical resection. After surgery, 21 patients received adjuvant EBRT and radioactive iodine therapy (EBRT group) and 35 patients were treated with radioactive iodine therapy (control group). Results: The age range was 26-87 years (median, 56 years). The median follow-up period was 43 months (range, 4 to 145 months). EBRT doses ranged from 50.4 to 66 Gy (median, 60 Gy). Esophagus invasion and gross residual disease was more frequent in the EBRT group. In the control group, local recurrence developed in 9 (9/35, 26%) and new distant metastasis in 2 (2/35, 6%) patients, occurring 4 to 68 months (median, 37 months) and 53 to 68 months (median, 60 months) after surgery, respectively. Two patients had simultaneous local recurrence and new distant metastasis. There was one local failure in the EBRT group at 18 months after surgery (1/21, 5%). The 5-year LFFS was 95% in the EBRT group and 63% in the control group (p = 0.103). In the EBRT group, one late grade 2 xerostomia was developed. Conclusion: Although, EBRT group had a higher incidence of esophagus invasion and gross residual disease, EBRT group showed a better 5-year LFFS. Adjuvant EBRT may have contributed to the better LFFS in these patients.