Journal article
Recurrent Laryngeal Nerve Invasion by Thyroid Cancer: Laryngeal Function and Survival Outcomes
The Laryngoscope, Vol.132(11), pp.2285-2292
11/2022
DOI: 10.1002/lary.30115
PMID: 35363394
Abstract
Recurrent laryngeal nerve (RLN) invasion by thyroid carcinoma represents an advanced disease status with potentially significant co-morbidity.
In a retrospective single-center study, we included patients with invaded RLNs operated on while using nerve monitoring techniques. We studied pre-, intra-, and postoperative parameters associated with postoperative vocal cord paralysis (VCP); 5-year recurrence-free survival (RFS); and 5-year overall survival (OS) in addition to two subgroup analyses of postoperative VCP in patients without preoperative VCP and based on source of RLN invasion.
Of 65 patients with 66 nerves-at-risk, 39.3% reported preoperative voice complaints. Preoperative VCP was documented in 43.5%. The RLN was invaded by primary tumor in 59.3% and nodal metastasis in 30.5%. Papillary thyroid carcinoma was the most common pathologic subtype (80%). After 6 months, 81.8% had VCP. Complete tumor resection of the RLN was not associated with 5-year RFS (p = 0.24) or 5-year OS (p = 0.9). Resecting the RLN did not offer statistically significant benefit on 5-year RFS (p = 0.5) or 5-year OS (p = 0.38). Radioactive Iodine (RAI) administration was associated with improvement in 5-year RFS (p = 0.006) and 5-year OS (p = 0.004). Patients without preoperative VCP had higher IONM amplitude compared with patients with VCP. After a mean follow-up of 65.8 months, 35.9% of patients had distant metastases, whereas 36.4% had recurrence.
Preoperative VCP accompanies less than half of patients with RLN invasion. Invaded RLNs may have existent electrophysiologic stimulability. Complete tumor resection and RLN resection were not associated with better 5-year RFS or OS, but postoperative RAI was.
4 Laryngoscope, 132:2285-2292, 2022.
Details
- Title: Subtitle
- Recurrent Laryngeal Nerve Invasion by Thyroid Cancer: Laryngeal Function and Survival Outcomes
- Creators
- Jennifer A Brooks - University of Rochester Medical CenterAmr H Abdelhamid Ahmed - Massachusetts Eye and Ear InfirmaryZaid Al-Qurayshi - Department of Otolaryngology-Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USADipti Kamani - Massachusetts Eye and Ear InfirmaryNatalia Kyriazidis - SUNY Upstate Medical UniversityRebecca Jean Hammon - Education NorthwestHongzhi Ma - Beijing Tongren HospitalNiranjan Sritharan - Nepean HospitalIsaac Wasserman - Harvard UniversityLily N Trinh - Massachusetts Eye and Ear InfirmaryAyaka J Iwata - Kaiser Permanente Santa Clara Medical CenterYoshiyuki Saito - Massachusetts Eye and Ear InfirmarySelen Soylu - Istanbul Metropolitan MunicipalityGregory W Randolph - Massachusetts Eye and Ear InfirmaryR Score Research Group
- Resource Type
- Journal article
- Publication Details
- The Laryngoscope, Vol.132(11), pp.2285-2292
- DOI
- 10.1002/lary.30115
- PMID
- 35363394
- ISSN
- 0023-852X
- eISSN
- 1531-4995
- Language
- English
- Date published
- 11/2022
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984702820802771
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