Preoperative CT Predictors for Thyroid Gland Tumour Involvement in Laryngeal Carcinoma

Abstract Objective The aim of our study is to assess the role of preoperative computed tomography (CT) in determining the risk of thyroid gland invasion (TGI) in advanced laryngeal carcinoma. Background Thyroidectomy is generally recommended in patients undergoing total laryngectomy (TLE) for advanced laryngeal cancer. Methods In a retrospective analysis of 61 patients after TLE with thyroidectomy, we evaluated the predictive value of preoperative CT scan parameters for TGI. Results In all 5 cases of TGI (8%), the adjacent lobe of the thyroid gland was involved. The statistically significant risk parameters were tumour subglottic extension exceeding 15 mm ( p = 0.039), cricoid cartilage chondrolysis ( p = 0.01), and cricothyroid membrane invasion ( p = 0.007) on CT scans. Both cricoid cartilage chondrolysis and cricothyroid membrane invasion were also identified as independent predictors for TGI (OD 18, p = 0.028 and OD 20, p = 0.02) through regression analysis. Conclusion Given the low incidence of occult TGI, we do not believe that routine elective thyroidectomy to be justified. In an elective setting, a hemithyroidectomy is sufficient and should be considered for tumours exhibiting subglottic extension and/or signs of thyroid or cricoid cartilage chondrolysis, or infiltration of the cricothyroid membrane on preoperative CT scans.