title: Thyroid Gland Involvement in Carcinoma Larynx and Hypopharynx-Predictive Factors and Prognostic Significance.
abstract: BACKGROUND
  Intraoperative management of thyroid gland in laryngeal and hypopharyngeal cancer is controversial.
  
  
  OBJECTIVE
  The objectives of this study were to determine the incidence of thyroid gland invasion in patients undergoing surgery for laryngeal or hypopharyngeal carcinoma, to assess predictive factors and to assess the prognosis in patients with and without thyroid gland invasion.
  
  
  METHODS
  One hundred and thirty-three patients who underwent surgery for carcinoma larynx and hypopharynx from 2006 to 2010 were reviewed retrospectively. Surgical specimens were examined to determine the incidence of thyroid gland invasion and predictive factors were analysed. The recurrence rate and the survival in patients with and without thyroid gland invasion were also analysed.
  
  
  RESULTS
  Out of the 133 patients with carcinoma larynx and hypopharynx who underwent surgery, histological thyroid gland invasion was observed in 28/133 (21%) patients. Significant relationship was found between histological thyroid gland invasion and preoperative evidence of thyroid cartilage erosion by CT scan and also when gross thyroid gland involvement observed during surgery. There is significant association between thyroid gland invasion when there is upper oesophageal or subglottic involvement.
  
  
  CONCLUSIONS
  After analysing the retrospective data from our study, we would like to suggest that thyroid gland need not be removed routinely in all laryngectomies, unless there is advanced disease with thyroid cartilage erosion and gross thyroid gland involvement or disease with significant subglottic or oesophageal involvement.
authors.affiliation: Additional Professor, Department of Surgical Oncology, Regional Cancer Centre , Trivandrum, Kerala, India .
authors.forename: Elizabeth Mathew
authors.initials: EM
authors.lastname: Iype
authors.affiliation: MCh trainee, Department of Surgical Oncology, Regional Cancer Centre , Trivandrum, Kerala, India .
authors.forename: Vijay
authors.initials: V
authors.lastname: Jagad
authors.affiliation: Fellow in Head and Neck Surgical Oncology, Department of Surgical Oncology, Regional Cancer Centre , Trivandrum, Kerala, India .
authors.forename: Santhosh Kumar
authors.initials: SK
authors.lastname: Nochikattil
authors.affiliation: Additional Professor, Department of Surgical Oncology, Regional Cancer Centre , Trivandrum, Kerala, India .
authors.forename: Bipin T
authors.initials: BT
authors.lastname: Varghese
authors.affiliation: Director, Regional Cancer Centre , Trivandrum, Kerala, India .
authors.forename: Paul
authors.initials: P
authors.lastname: Sebastian
keywords: Carcinoma; Infiltration; Thyroidectomy