A Study of Patients with Papillary Thyroid Cancer who Underwent Tracheal Shaving

Abstract

Invasion of thyroid cancer into other organs is an important adverse prognostic factor. Macroscopically, in cases where invasion into the trachea has not reached as far as the tracheal mucosa surface, we perform tracheal surface resection (hereafter tracheal shaving).
We retrospectively investigated local control rates, metastasis rates and survival rates in patients who had undergone tracheal shaving. Our subjects were 22 papillary thyroid carcinoma patients in whom tracheal shaving had been performed at the Head and Neck Oncology Department of the Cancer Institute Hospital between January 1994 and December 2005. In 21 of the 22 patients (95%), the carcinoma was locally controlled;in 6 patients (27%), metastasis was observed. With 2 patients dying from causes other than cancer, 5-year and 10-year survival rates were 93% and 41%, respectively. Currently, 2 of the thyroid carcinoma patients still survive.
Compared to full-thickness resection, following tracheal shaving, patients had a higher QOL and the carcinoma was well controlled locally as long as it had not invaded as far as the tracheal mucosa surface. However, compared with papillary thyroid carcinoma with no tracheal invasion, metastasis is common and invasion of organs other than the trachea is frequent, putting many patients into the high risk group. It is therefore considered necessary to carefully monitor the clinical course of such patients paying particular attention to metastasis to other locations.