Tracheal and Cricotracheal Resection With End-to-End Anastomosis for Locally Advanced Thyroid Cancer: A Systematic Review of the Literature on 656 Patients

Airway involvement by advanced thyroid carcinoma (TC) constitutes a negative prognosticator, besides being a critical clinical issue since it represents one of the most frequent causes of death in locally advanced disease. It is generally agreed that, for appropriate laryngo-tracheal patterns of inv...

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Autores principales:	Cesare Piazza, Davide Lancini, Michele Tomasoni, Anil D’Cruz, Dana M. Hartl, Luiz P. Kowalski, Gregory W. Randolph, Alessandra Rinaldo, Jatin P. Shah, Ashok R. Shaha, Ricard Simo, Vincent Vander Poorten, Mark Zafereo, Alfio Ferlito
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	thyroid cancer airway surgery tracheal resection crico-tracheal resection Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/a090470981f3487aad82d651d2be8128
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spelling	oai:doaj.org-article:a090470981f3487aad82d651d2be81282021-11-11T10:20:29ZTracheal and Cricotracheal Resection With End-to-End Anastomosis for Locally Advanced Thyroid Cancer: A Systematic Review of the Literature on 656 Patients1664-239210.3389/fendo.2021.779999https://doaj.org/article/a090470981f3487aad82d651d2be81282021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fendo.2021.779999/fullhttps://doaj.org/toc/1664-2392Airway involvement by advanced thyroid carcinoma (TC) constitutes a negative prognosticator, besides being a critical clinical issue since it represents one of the most frequent causes of death in locally advanced disease. It is generally agreed that, for appropriate laryngo-tracheal patterns of invasion, (crico-)tracheal resection and primary anastomosis [(C)TRA] is the preferred surgical technique in this clinical scenario. However, the results of long-term outcomes of (C)TRA are scarce in the literature, due to the rarity of such cases. The relative paucity of data prompts careful review of the available relevant series in order to critically evaluate this surgical technique from the oncologic and functional points of view. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement on the PubMed, Scopus, and Web of Science databases. English-language surgical series published between January 1985 and August 2021, reporting data on ≥5 patients treated for TC infiltrating the airway by (C)TRA were included. Oncologic outcomes, mortality, complications, and tracheotomy-dependency rates were assessed. Pooled proportion estimates were elaborated for each end-point. Thirty-seven studies were included, encompassing a total of 656 patients. Pooled risk of perioperative mortality was 2.0%. Surgical complications were reported in 27.0% of patients, with uni- or bilateral recurrent laryngeal nerve palsy being the most common. Permanent tracheotomy was required in 4.0% of patients. Oncologic outcomes varied among different series with 5- and 10-year overall survival rates ranging from 61% to 100% and 42.1% to 78.1%, respectively. Five- and 10-year disease specific survival rates ranged from 75.8% to 90% and 54.5% to 62.9%, respectively. Therefore, locally advanced TC with airway invasion treated with (C)TRA provides acceptable oncologic outcomes associated with a low permanent tracheotomy rate. The reported incidence of complications, however, indicates the need for judicious patient selection, meticulous surgical technique, and careful postoperative management.Cesare PiazzaCesare PiazzaDavide LanciniMichele TomasoniMichele TomasoniAnil D’CruzDana M. HartlLuiz P. KowalskiGregory W. RandolphAlessandra RinaldoJatin P. ShahJatin P. ShahAshok R. ShahaRicard SimoVincent Vander PoortenVincent Vander PoortenMark ZafereoAlfio FerlitoFrontiers Media S.A.articlethyroid cancerairwaysurgerytracheal resectioncrico-tracheal resectionDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENFrontiers in Endocrinology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	thyroid cancer airway surgery tracheal resection crico-tracheal resection Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	thyroid cancer airway surgery tracheal resection crico-tracheal resection Diseases of the endocrine glands. Clinical endocrinology RC648-665 Cesare Piazza Cesare Piazza Davide Lancini Michele Tomasoni Michele Tomasoni Anil D’Cruz Dana M. Hartl Luiz P. Kowalski Gregory W. Randolph Alessandra Rinaldo Jatin P. Shah Jatin P. Shah Ashok R. Shaha Ricard Simo Vincent Vander Poorten Vincent Vander Poorten Mark Zafereo Alfio Ferlito Tracheal and Cricotracheal Resection With End-to-End Anastomosis for Locally Advanced Thyroid Cancer: A Systematic Review of the Literature on 656 Patients
description	Airway involvement by advanced thyroid carcinoma (TC) constitutes a negative prognosticator, besides being a critical clinical issue since it represents one of the most frequent causes of death in locally advanced disease. It is generally agreed that, for appropriate laryngo-tracheal patterns of invasion, (crico-)tracheal resection and primary anastomosis [(C)TRA] is the preferred surgical technique in this clinical scenario. However, the results of long-term outcomes of (C)TRA are scarce in the literature, due to the rarity of such cases. The relative paucity of data prompts careful review of the available relevant series in order to critically evaluate this surgical technique from the oncologic and functional points of view. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement on the PubMed, Scopus, and Web of Science databases. English-language surgical series published between January 1985 and August 2021, reporting data on ≥5 patients treated for TC infiltrating the airway by (C)TRA were included. Oncologic outcomes, mortality, complications, and tracheotomy-dependency rates were assessed. Pooled proportion estimates were elaborated for each end-point. Thirty-seven studies were included, encompassing a total of 656 patients. Pooled risk of perioperative mortality was 2.0%. Surgical complications were reported in 27.0% of patients, with uni- or bilateral recurrent laryngeal nerve palsy being the most common. Permanent tracheotomy was required in 4.0% of patients. Oncologic outcomes varied among different series with 5- and 10-year overall survival rates ranging from 61% to 100% and 42.1% to 78.1%, respectively. Five- and 10-year disease specific survival rates ranged from 75.8% to 90% and 54.5% to 62.9%, respectively. Therefore, locally advanced TC with airway invasion treated with (C)TRA provides acceptable oncologic outcomes associated with a low permanent tracheotomy rate. The reported incidence of complications, however, indicates the need for judicious patient selection, meticulous surgical technique, and careful postoperative management.
format	article
author	Cesare Piazza Cesare Piazza Davide Lancini Michele Tomasoni Michele Tomasoni Anil D’Cruz Dana M. Hartl Luiz P. Kowalski Gregory W. Randolph Alessandra Rinaldo Jatin P. Shah Jatin P. Shah Ashok R. Shaha Ricard Simo Vincent Vander Poorten Vincent Vander Poorten Mark Zafereo Alfio Ferlito
author_facet	Cesare Piazza Cesare Piazza Davide Lancini Michele Tomasoni Michele Tomasoni Anil D’Cruz Dana M. Hartl Luiz P. Kowalski Gregory W. Randolph Alessandra Rinaldo Jatin P. Shah Jatin P. Shah Ashok R. Shaha Ricard Simo Vincent Vander Poorten Vincent Vander Poorten Mark Zafereo Alfio Ferlito
author_sort	Cesare Piazza
title	Tracheal and Cricotracheal Resection With End-to-End Anastomosis for Locally Advanced Thyroid Cancer: A Systematic Review of the Literature on 656 Patients
title_short	Tracheal and Cricotracheal Resection With End-to-End Anastomosis for Locally Advanced Thyroid Cancer: A Systematic Review of the Literature on 656 Patients
title_full	Tracheal and Cricotracheal Resection With End-to-End Anastomosis for Locally Advanced Thyroid Cancer: A Systematic Review of the Literature on 656 Patients
title_fullStr	Tracheal and Cricotracheal Resection With End-to-End Anastomosis for Locally Advanced Thyroid Cancer: A Systematic Review of the Literature on 656 Patients
title_full_unstemmed	Tracheal and Cricotracheal Resection With End-to-End Anastomosis for Locally Advanced Thyroid Cancer: A Systematic Review of the Literature on 656 Patients
title_sort	tracheal and cricotracheal resection with end-to-end anastomosis for locally advanced thyroid cancer: a systematic review of the literature on 656 patients
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/a090470981f3487aad82d651d2be8128
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Tracheal and Cricotracheal Resection With End-to-End Anastomosis for Locally Advanced Thyroid Cancer: A Systematic Review of the Literature on 656 Patients

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