Long-term results and functional outcome after cervical evisceration in patients with thyroid cancer.
BACKGROUND
Surgical strategy in patients with thyroid cancer (TC) infiltrating the aerodigestive system is controversial. This study was undertaken to examine the long-term results of cervical evisceration (CE).


METHODS
Since 1995, 14 consecutive patients with advanced TC underwent total laryngectomy (LE, n = 6) or esophagolaryngectomy (ELR, n = 8). Patients with unusual thyroid neoplasms or metastases to the thyroid (n = 3) were excluded. For esophageal reconstruction, free jejunal grafts (n = 6) and gastric tubes (n = 2) were used.


RESULTS
Procedure-related morbidity and mortality were 42% and 14%, respectively. ELR was associated with a significant higher frequency of complications and reoperations compared with LE. Twelve-month and 30-month survival rates were 73% and 55%, respectively; 85% of the patients were satisfied with the surgical results. There were no long-term problems concerning food intake in the ELR patients. Two ELR patients were able to learn a substitutive voice.


CONCLUSIONS
Cervical evisceration in patients with TC is associated with significant perioperative morbidity and mortality requiring careful patient selection. Regarding long-term survival, local tumor control, and patient's satisfaction, however, CE should be taken into account in suitable patients with advanced TC.
Brauckhoff
Michael
M
Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany. michael.brauckhoff@medizin.uni-halle.de
Meinicke
Anja
A
Bilkenroth
Udo
U
Lorenz
Kerstin
K
Brauckhoff
Katrin
K
Gimm
Oliver
O
Thanh
Phuong Nguyen
PN
Dralle
Henning
H
D000368:Aged; D018572:Disease-Free Survival; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006801:Humans; D007825:Laryngectomy / Q000009:adverse effects / Q000379:methods; D007830:Larynx / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009361:Neoplasm Invasiveness; D011379:Prognosis; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome