title: Tracheal and Crico-Tracheal Resection and Anastomosis for Malignancies Involving the Thyroid Gland and the Airway.
abstract: OBJECTIVE
  To evaluate outcomes in different malignancies involving the thyroid and infiltrating the airway submitted to tracheal (TRA) or crico-tracheal resection and anastomosis (CTRA).
  
  
  METHODS
  Retrospective charts review of 27 patients affected by thyroid malignancies involving the airway treated by TRA/CTRA in a single academic institution. Kaplan-Meier curves were used to evaluate the overall (OS) and disease-specific (DSS) survivals and local (LC) and loco-regional control (LRC). Impact on survival of age, comorbidities, previous radiotherapy, types of TRA/CTRA, Shin's stage (II, III, IV), grading (well vs poorly differentiated), and length of airway resected was calculated by the log-rank test.
  
  
  RESULTS
  Overall survival and DSS at 3 and 5 years were 82.3% and 71.6%, respectively. Local control and LRC in the entire group were 82.3% at 3 and 5 years. Crico-tracheal resection and anastomosis involving the cricoid arch and plate (type C) and tumor differentiation significantly affected OS and DSS (both P < .001). Type C CTRA and tumor differentiation significantly impacted on LC (P = .002 and P = .009, respectively).
  
  
  CONCLUSIONS
  Grading and extension of CTRA to the cricoid plate are the most important factors for oncologic outcomes in thyroid malignancies infiltrating the airway. Except for poorly differentiated tumors, TRA/CTRA allows adequate LC even in advanced stage lesions involving the crico-tracheal junction.
authors: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy ceceplaza@libero.it.
authors: Cesare
authors: C
authors: Piazza
authors: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy.
authors: Francesca
authors: F
authors: Del Bon
authors: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy.
authors: Diego
authors: D
authors: Barbieri
authors: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy.
authors: Paola
authors: P
authors: Grazioli
authors: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy.
authors: Alberto
authors: A
authors: Paderno
authors: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy.
authors: Pietro
authors: P
authors: Perotti
authors: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy.
authors: Davide
authors: D
authors: Lombardi
authors: Department of Otorhinolaryngology-Head and Neck Surgery, University of Genoa, Genoa, Italy.
authors: Giorgio
authors: G
authors: Peretti
authors: Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy.
authors: Piero
authors: P
authors: Nicolai
mesh_terms: D000368:Aged; D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D000714:Anastomosis, Surgical / Q000379:methods*; D044963:Biopsy, Fine-Needle / Q000379:methods; D003413:Cricoid Cartilage / Q000473:pathology / Q000601:surgery; D004724:Endoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D014132:Trachea / Q000473:pathology / Q000601:surgery; D014140:Tracheotomy / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome
keywords: airway; anastomosis; cricoid; resection; thyroid cancer; trachea