title: Resection margins and prognosis in locally invasive thyroid cancer.
abstract: BACKGROUND
  Invasive thyroid cancer is rare, and the extent of surgery controversial. The purpose of this study was to present and evaluate therapeutic prognostic factors.
  
  
  METHODS
  We conducted a retrospective single-center study of differentiated thyroid carcinoma invading the larynx, trachea, and/or esophagus treated surgically with macroscopic complete resection.
  
  
  RESULTS
  Forty-six patients (average age, 57 years; average follow-up, 4 years) were included. Free margins (R0) were obtained for 22 of 46 (49%) and microscopic residual tumor was present after surgery (R1) for 24 (51%). Ten-year actuarial local control was 100% for R0 and 75% for R1 (p = .08). Five-year local control was lower for recurrent tumors versus inaugurally invasive disease (63% vs 87%; log-rank p = .011). Five-year and 10-year actuarial disease-specific survival (DSS) was correlated with preoperative distant metastases (100% and 87%, respectively, for M0 vs 68% and 34% for M1; p = .01).
  
  
  CONCLUSIONS
  A trend toward lower local control was observed for R1 versus R0. The morbidity of surgery should be weighed against the prognosis if metastases are present.
authors.affiliation: Department of Head and Neck Oncology-Head and Neck Surgery, Institut Gustave Roussy and University of Paris-Sud, France.
authors.forename: Dana M
authors.initials: DM
authors.lastname: Hartl
authors.forename: Sophie
authors.initials: S
authors.lastname: Zago
authors.forename: Sophie
authors.initials: S
authors.lastname: Leboulleux
authors.forename: Haïtham
authors.initials: H
authors.lastname: Mirghani
authors.forename: Desirée
authors.initials: D
authors.lastname: Déandreis
authors.forename: Eric
authors.initials: E
authors.lastname: Baudin
authors.forename: Martin
authors.initials: M
authors.lastname: Schlumberger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018265:Carcinoma, Papillary, Follicular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002648:Child; D016629:Esophagectomy; D004947:Esophagus / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007825:Laryngectomy; D007830:Larynx / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D018365:Neoplasm, Residual; D010614:Pharynx / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy; D014132:Trachea / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
keywords: cancer; larynx; margins; thyroid; trachea