Cervical exenteration and its variants for locally advanced thyroid cancer: when, why, and how?
Journal
Current opinion in otolaryngology & head and neck surgery
ISSN: 1531-6998
Titre abrégé: Curr Opin Otolaryngol Head Neck Surg
Pays: United States
ID NLM: 9417024
Informations de publication
Date de publication:
01 Apr 2023
01 Apr 2023
Historique:
entrez:
13
3
2023
pubmed:
14
3
2023
medline:
15
3
2023
Statut:
ppublish
Résumé
To describe the modern surgical approach for management of advanced thyroid cancers infiltrating the cervicovisceral axis with special attention to well differentiated tumors not amenable to organ-sparing techniques. In particular, cervical exenteration, herein defined as the sum of total thyroidectomy, central compartment and lateral neck dissections, variously associated with total laryngectomy and possible partial or total pharyngoesophagectomy, represents an extreme surgical procedure that, in properly selected cases, allows for reasonable palliation of central compartment life-threatening signs/symptoms if not cure for an advanced oncologic condition. Cervical exenteration is not contraindicated by the presence of limited distant metastases at presentation. Even though it requires that the patient is in general good health as it can be associated with a number of complications and long in-hospital stay, when appropriately planned and performed according to the most recent reconstructive nuances, it allows good oncologic outcomes that are not inferior to those described for similarly advanced primaries of the upper aerodigestive tract. In addition, quality of life and functional results are not significantly different from those described after total laryngectomy for primary laryngeal squamous cell carcinomas. Cervical exenteration requires a tertiary, expert, multidisciplinary effort in terms of diagnosis, surgical performance, and postoperative care. A patient-centered decision process is strongly warranted taking into consideration alternative therapeutic and symptom-based palliative strategies.
Identifiants
pubmed: 36912217
doi: 10.1097/MOO.0000000000000873
pii: 00020840-202304000-00002
doi:
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
65-72Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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