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Preoperative tracheostomy is associated with thyroid gland invasion and poorer prognosis in laryngectomized patients

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Abstract

Purpose

Patients with laryngeal cancer may necessitate tracheostomy placement to alleviate compromised airways. However, the impact of tracheostomy on thyroid gland invasion and its implications for prognosis in individuals who further undergo total laryngectomy remains unclear. This study aimed to assess thyroid gland invasion rates and explore the 5-years disease-free and overall survival in laryngectomized patients stratified by preoperative tracheostomy.

Methods

All patients who underwent total laryngectomy for laryngeal cancer between 2003 and 2023 at a tertiary referral center were retrospectively reviewed. Logistic univariable and multivariable regressions were performed to identify factors associated with thyroid gland invasion. Survival analyses were performed using the Kaplan–Meier estimator.

Results

A total of 119 laryngectomized patients were included (mean age: 63 ± 10 years, range 35–89, 110 [92.4%] males); 27 (22.7%) underwent preoperative tracheostomy. In 16 (13.4%) patients, tumor cells were found within the thyroid gland. In a multivariable analysis, thyroid gland invasion was independently associated with preoperative tracheostomy (odds ratio [OR] 3.13, 95% confidence interval [CI] 2.45–6.19), pN2 + (OR 2.13, 95% CI 1.8–5.14), positive margins (OR 1.36, 95% CI 1.01–1.77), lower 5-year disease-free survival (38% vs. 57%, p = 0.01), and lower 5-year overall survival (40% vs. 56%, p = 0.03).

Conclusion

Preoperative tracheostomy is an independent predictive factor for thyroid gland invasion and has adverse oncological outcomes in laryngectomized patients. Conversely, the rates of thyroid gland invasion are low when tracheostomy was not performed beforehand.

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Data availability

Generated/analyzed data in this study will be made available to researchers upon reasonable request to the corresponding author.

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Funding

No funds, grants, or other support were received for conducting this study.

Author information

Authors and Affiliations

  1. Department of Otolaryngology - Head and Neck Surgery, Rambam Health Care Campus, 8 Ha’Aliya Street, 3109601, Haifa, Israel

    Roee Noy, Nadeem Habashi, Jacob Cohen & Yotam Shkedy

  2. The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel

    Roee Noy, Nadeem Habashi, Sharon Akrish, Jacob Cohen & Yotam Shkedy

  3. Department of Pathology, Rambam Health Care Campus, Haifa, Israel

    Sharon Akrish

Authors
  1. Roee Noy
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  2. Nadeem Habashi
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  3. Sharon Akrish
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  4. Jacob Cohen
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  5. Yotam Shkedy
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Contributions

RN—concept, design, conduct, data collection, analysis, manuscript drafting; NH—design, data collection, manuscript drafting; SA—data collection, manuscript drafting; JTC—design, data collection, manuscript drafting; YS—concept, design, conduct, manuscript drafting.

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Correspondence to Roee Noy.

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The authors declare no potential conflicts of interest.

Ethical standard

The manuscript was written under the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies.

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The institutional review board of the Rambam Healthcare Campus (0298-22-RMB) approved this study.

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Noy, R., Habashi, N., Akrish, S. et al. Preoperative tracheostomy is associated with thyroid gland invasion and poorer prognosis in laryngectomized patients. Eur Arch Otorhinolaryngol 281, 935–943 (2024). https://doi.org/10.1007/s00405-023-08302-4

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  • DOI: https://doi.org/10.1007/s00405-023-08302-4

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