Functional results and quality of life after tracheal resection for locally invasive thyroid cancer.
BACKGROUND
Local invasion of the upper aerodigestive tract by thyroid cancer, although uncommon, is a serious cause of morbidity and mortality. The impact of aerodigestive tract resection on the functional status and quality of life of the patient has not previously been investigated.


METHODS
Patients with locally invasive thyroid cancer were included in a prospective surgical protocol. Swallowing function was assessed with barium swallow at 7 days and 1 month postoperatively. Postoperative quality of life (QOL) was measured using a validated head and neck QOL instrument.


RESULTS
Seven patients underwent airway resection for locally invasive recurrent thyroid cancer in the period 1999 to 2001. At 1 week postoperative 3 of 7 (43%) had no evidence of aspiration on barium swallow. At 4 weeks 6 of 7 (86%) had no aspiration. Postoperative QOL scores in the domains of eating function (85.2) and emotional status (78.6) were significantly better than those of a comparison group undergoing treatment for cancers of the oropharynx, P = 0.012 and P = 0.0077, respectively.


CONCLUSIONS
Tracheal resection for locally invasive thyroid cancer is associated with a return to full dietary intake within 4 weeks of surgery in most cases. Function and QOL after this type of surgery are acceptable.
Sywak
Mark
M
Division of Surgical Oncology, Tom Baker Cancer Center and University of Calgary, Calgary, Alberta, Canada.
Pasieka
Janice L
JL
McFadden
Sean
S
Gelfand
Gary
G
Terrell
Jeffrey
J
Dort
Joseph
J
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D011183:Postoperative Complications; D011446:Prospective Studies; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D012135:Respiratory Sounds / Q000209:etiology; D013964:Thyroid Neoplasms / Q000150:complications / Q000532:radiotherapy / Q000601:surgery*; D014132:Trachea / Q000502:physiology / Q000601:surgery*; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000209:etiology