Surgical Treatment Of Well Differertiated Thyroid Carcinoma Invading Tracheal

Objective To evaluate surgical treatment modalities and its clinical significance of differentiated thyroid carcinoma(WDTC) with tracheal invasion.Methods Clinical data were reviewed and analyzed in 40 patients treated for WDTC with tracheal invasion from January 2001 to October 2012. The different surgical modalities were applied according to the extent of tracheal invasion.Group A:shave excision(25 cases);Group B:radical surgery including tracheal window resection(8 cases) and total laryngectomy(4 cases);Group C:incomplete tumor resectiong(3 cases).These patients received radionuclide therapy and endocrine therapy after surgery.Survival rate was evaluated using the Kaplan-Meier analysis.Results There were follow-up period of 5-10 years of which two was missed.The overall 5-year patient survival rates were 92.0%、91.6% and 33.3%.The overall 10-year patient survival rates were 80.0% and 71.4%.The patients who received tracheal window resection were within six months after the removal of the tracheal tube,these does not appear significant Complications, such as tracheal stenosis.The patients get a good quality of life.One patient had lung transfer after surgery at 3 years,currently survival with tumor.One of the total laryngectomy patients appeared pharyngeal leak and got better after dressing treatment The difference of Group A and B survival (P=0.659>0.05) was not statistically significant, the survival of Group C was significantly decreased (P=0.000<0.05).Conclusion Differentiated thyroid cancer patients with tracheal invasion should take a more aggressive surgical treatment.We should select the appropriate surgical approach to reduce the recurrence according to the trachea range of different tumor invasion.The surgical operation should remove all tumor lesions and organs in the premise of reserved function,so patients have a greater survival benefit.