CARTILAGE-SHAVING PROCEDURE FOR THE CONTROL OF TRACHEAL CARTILAGE INVASION BY THYROID-CARCINOMA

This study was carried out to ascertain whether the cartilage-shaving procedure is appropriate to control thyroid carcinoma with tracheal ca rtilage invasion. Of 432 thyroid carcinoma patients treated between 19 79 and 1988, 16 had tracheal cartilage invasion only. This patient pop ulation was made up of 3 men and 13 women, with a mean age of 55.8 yea rs. Fourteen were diagnosed histologically as having papillary carcino ma and the remaining two as having follicular carcinoma. Cartilage sha ving was the primary treatment in all the patients, and subsequent rad ioactive iodine (I-131) or external-beam radiotherapy was administered to control any possible residual disease. Lifelong thyroid hormone re placement was instituted in all patients, and the follow-up period ave raged 70.7 months. Only four of the 16 patients remained disease free; the disease was not controlled in the other 12, and seven of this lat ter group eventually died of their disease. We feel that a more extens ive resection procedure than cartilage shaving should be considered, e ven in patients with superficial tracheal invasion, to increase the di sease-free survival rate.