Role of Thyroidectomy in Total Laryngectomy for Laryngeal Squamous Cell Carcinoma- Should it be Spared?

Monday, October 13, 2025

4:48 PM - 4:54 PM EDT

Location: 127

Disclosure(s):

Francisco J. Garratón Gutiérrez, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction:

Objectives: 1) Evaluate the incidence of thyroid gland invasion in adult Hispanic patients with laryngeal squamous cell carcinoma (SCCA) who underwent total laryngectomy 2) Promote thyroid preservation by stratifying laryngeal SCCA tumor characteristics to identify patients at higher risk of thyroid gland invasion and those for whom thyroidectomy can be spared 3) Understand the behavior of the involvement of thyroid tissue by laryngeal SCCA in patients who undergo total laryngectomy 4) Assess comorbidities associated with thyroidectomy in these patients

Methods: We present a retrospective clinicopathological analysis of patients with laryngeal SCCA who underwent total laryngectomy with concomitant partial or total thyroidectomy from 2001-2022 in Puerto Rico Medical Center. Several tumor characteristics were evaluated for correlation with the rate of thyroid gland invasion. We conducted a pathologic analysis of thyroid tissue for involvement by the laryngeal tumor. Incidence of hypocalcemia requiring inpatient treatment after thyroidectomy was documented.

Results: All 107 patients included in our study were found with gross thyroid specimens. A total of 8 subjects (7.48%) presented with thyroid gland involvement by laryngeal SCCA. All had T4a disease, full thickness thyroid cartilage involvement, and bilateral primary tumor site involvement. Three thyroid pathologies that are not associated with laryngeal disease were found: follicular adenoma, micropapillary thyroid carcinoma, and papillary thyroid carcinoma. 43% (n=46) of subjects suffered from hypocalcemia with 43.5% (n=20) requiring IV replacement. Most tissues evaluated (52.3%, n= 56) came from T4 laryngeal SCCA.

Conclusions: Thyroid gland involvement is an uncommon manifestation of laryngeal SCCA. Sparing the thyroid gland during total laryngectomy may reduce the comorbidities associated with this surgery in appropriately selected patients. Risk assessment of thyroid gland involvement must be evaluated preoperatively and intraoperatively before performing a partial or total thyroidectomy to reduce long term complications.

Presenting Author(s)

Francisco J. Garratón Gutiérrez, MD

OTO-HNS PGY4 resident
University of Puerto Rico School of Medicine
San Juan, PR, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Bianca V. Bonafont Reyes, MD

PGY-1 Preliminary General Surgery Resident
University of Puerto Rico School of Medicine
Toa Baja, PR, United States

Disclosure information not submitted.
AB

Antonio E. Bures Rodriguez, MD

Chief Resident
University of Puerto Rico School of Medicine
San Juan, PR, United States

Disclosure information not submitted.

Co-Author(s)

MC

Mario A. Corona Ruiz, MD

University of Puerto Rico School of Medicine, United States

Disclosure information not submitted.
Bianca V. Bonafont Reyes, MD

PGY-1 Preliminary General Surgery Resident
University of Puerto Rico School of Medicine
Toa Baja, PR, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

JP

Jeamarie Pascual Marrero, MD

University of Puerto Rico, United States

Disclosure information not submitted.