title: Thyroid gland invasion in advanced squamous cell carcinoma of the larynx and hypopharynx.
abstract: BACKGROUND
  Squamous cell carcinoma of the larynx and hypopharynx has the potential to invade the thyroid gland. Despite this risk, the proposition of either partial or total thyroidectomy as part of the surgical treatment of all such cases remains controversial.
  
  
  OBJECTIVE
  To evaluate the frequency of invasion of the thyroid gland in patients with advanced laryngeal or hypopharyngeal squamous cell carcinoma submitted to total laryngectomy or pharyngolaryngectomy and thyroidectomy; to determine whether clinic-pathological characteristics can predict glandular involvement.
  
  
  METHODS
  A retrospective case series with chart review, from January 1998 to July 2013, was undertaken in a tertiary care university medical center. An inception cohort of 83 patients with larynx/hypopharynx squamous cell carcinoma was considered. All patients had advanced stage disease (clinically T3-T4) and underwent total laryngectomy or total pharyngolaryngectomy in association with thyroidectomy. Adjuvant therapy was indicated when tumor or neck conditions required. Frequency of thyroid cartilage invasion was calculated; univariate and multivariate analysis of demographic, clinical and pathological characteristics associated with cartilage invasion were performed.
  
  
  RESULTS
  The overall frequency of invasion of the thyroid gland was 18.1%. Glandular involvement was associated with invasion of the following structures: anterior commissure (odds ratio=5.13; 95% confidence interval 1.07-24.5), subglottis (odds ratio=12.44; 95% confidence interval 1.55-100.00) and cricoid cartilage (odds ratio=15.95; 95% confidence interval 4.23-60.11).
  
  
  CONCLUSIONS
  Invasion of the thyroid gland is uncommon in the context of laryngopharyngeal squamous cell carcinoma. Clinical and pathological features such as invasion of the anterior commissure, subglottis and cricoid cartilage are more associated with glandular invasion.
authors.affiliation: Universidade Federal de São Paulo, Departamento de Otorrinolaringologia Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil.
authors.forename: João
authors.initials: J
authors.lastname: Mangussi-Gomes
authors.affiliation: Universidade Federal de São Paulo, Departamento de Otorrinolaringologia Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil. Electronic address: fernandodanelon@me.com.
authors.forename: Fernando
authors.initials: F
authors.lastname: Danelon-Leonhardt
authors.affiliation: Universidade Federal de São Paulo, Departamento de Otorrinolaringologia Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil.
authors.forename: Guilherme Figner
authors.initials: GF
authors.lastname: Moussalem
authors.affiliation: Universidade Federal de São Paulo, Departamento de Otorrinolaringologia Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil.
authors.forename: Nicolas Galat
authors.initials: NG
authors.lastname: Ahumada
authors.affiliation: Universidade Federal de São Paulo, Departamento de Otorrinolaringologia Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil.
authors.forename: Cleydson Lucena
authors.initials: CL
authors.lastname: Oliveira
authors.affiliation: Universidade Federal de São Paulo, Departamento de Otorrinolaringologia Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil; Universidade de São Paulo, Laboratório de Pesquisas Clínicas - LIM-32, São Paulo, SP, Brazil.
authors.forename: Flávio Carneiro
authors.initials: FC
authors.lastname: Hojaij
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology* / Q000601:surgery; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000601:surgery; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010611:Pharyngectomy; D000077195:Squamous Cell Carcinoma of Head and Neck; D013961:Thyroid Gland / Q000473:pathology*
keywords: Carcinoma espinocelular; Faringectomia; Hipofaringe; Hypopharynx; Laringe; Laringectomia; Laryngectomy; Larynx; Pharyngectomy; Squamous cell carcinoma; Thyroidectomy; Tireoidectomia