Thyroid gland invasion in advanced laryngeal and hypopharyngeal carcinoma.

OBJECTIVES To assess the rate of thyroid gland invasion and the need for thyroidectomy in advanced laryngeal and hypopharyngeal carcinomas that require total laryngectomy. PATIENTS AND METHODS Between 1994 and 2001, 129 total laryngectomy with ipsilateral hemithyroidectomy and 14 total laryngopharyngectomy with total thyroidectomy operations were performed for primary squamous cell carcinoma of the larynx and hypopharynx. In the surgical specimens of the patients, the presence of tumor invasion to the thyroid cartilage and thyroid gland was evaluated retrospectively by light microscopic examination. RESULTS None of the laryngeal carcinoma patients had thyroid gland invasion whereas eight (57%) hypopharyngeal carcinoma patients had thyroid gland invasion. Twenty patients (16%) had evidence for thyroid cartilage invasion in the laryngeal carcinoma group. There were only three cases (21%) with thyroid cartilage invasion in the hypopharyngeal carcinoma patients. CONCLUSION There may be no need for performing thyroidectomy in all total laryngectomy cases. We recommend thyroidectomy during total laryngectomy in laryngeal carcinoma cases with subglottic extension and advanced hypopharyngeal tumors. Except for these two conditions, the assessment of extralaryngeal extension and thyroid gland invasion will guide whether thyroidectomy should be performed or not.