Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-17T10:16:22.222Z Has data issue: false hasContentIssue false
  • English
  • Français

Use of tracheal stenting in the palliation of anaplastic thyroid carcinoma: tertiary centre experience

Published online by Cambridge University Press:  20 May 2015

K Varadharajan ,
R Mathew ,
B Odutoye ,
P Williamson  and
B Madden
K Varadharajan*
Affiliation:
Department of ENT Surgery, West Middlesex University Hospital, London, UK
R Mathew
Affiliation:
Department of ENT, St George's Hospital, London, UK
B Odutoye
Affiliation:
Department of ENT, St George's Hospital, London, UK
P Williamson
Affiliation:
Department of ENT, St George's Hospital, London, UK
B Madden
Affiliation:
Department of Cardiothoracics and Intensive Care, St George's Hospital, London, UK
*
Address for correspondence: Mr Kiran Varadharajan, Department of ENT Surgery, West Middlesex University Hospital, Twickenham Road, Isleworth, London TW7 6AF, UK Fax: 0208 321 5906 E-mail: kiranvarad@doctors.org.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Anaplastic thyroid carcinoma is rare but carries a poor prognosis. Anaplastic thyroid carcinoma leads to tracheal compression, airway compromise and eventually death. Airway compromise, a particularly distressing symptom, can be palliated with tracheal stenting.

Method:

A retrospective case note analysis was conducted of patients diagnosed with anaplastic thyroid carcinoma between July 2003 and July 2013.

Results:

Twelve patients with anaplastic thyroid carcinoma were identified. Four patients underwent palliative tracheal stenting. Three patients had no dyspnoea at the time of stenting. Two stented patients subsequently developed dyspnoea secondary to stent migration; this was managed successfully with stent exchange. The other stented patient remained asymptomatic with regards to dyspnoea. All non-stented patients died with or from airway compromise.

Conclusion:

Tracheal stenting is a relatively safe and effective method for palliation of distressing airway symptoms in patients with anaplastic thyroid carcinoma. Early prophylactic tracheal stenting in anaplastic thyroid carcinoma may be an effective option to prevent development of airway compromise as the disease progresses.

Keywords

Thyroid NeoplasmsAnaplastic Thyroid CancerAirway ObstructionPalliative CareStent
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 6 , June 2015 , pp. 568 - 571
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Hundahl, SA, Fleming, ID, Fremgen, AM, Menck, HR. A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985–1995. Cancer 1998;83:2638–483.0.CO;2-1>CrossRefGoogle Scholar
2Are, C, Shaha, AR. Anaplastic thyroid carcinoma: biology, pathogenesis, prognostic factors, and treatment approaches. Ann Surg Oncol 2006;13:453–64CrossRefGoogle ScholarPubMed
3Kitamura, Y, Shimizu, K, Nagahama, M, Sugino, K, Ozaki, O, Mimura, T et al. Immediate causes of death in thyroid carcinoma: clinicopathological analysis of 161 fatal cases. J Clin Endocrinol Metab 1999;84:4043–9CrossRefGoogle ScholarPubMed
4Goyal, A, Gupta, R, Mehmood, S, Deo, S, Mishra, S, Bhatnagar, S. Palliative and end of life care issues of carcinoma thyroid patient. Indian J Palliat Care 2012;18:134–7CrossRefGoogle ScholarPubMed
5Ajithkumar, TV, Cook, N, Hatcher, H, Barrett, A. Oxford Desk Reference: Oncology. Oxford: Oxford University Press, 2011;532Google Scholar
6Mazzaferri, EL, Harmer, C, Mallick, UK, Kendall-Taylor, P. Practical Management of Thyroid Cancer: A Multidisciplinary Approach. London: Springer, 2006;91CrossRefGoogle Scholar
7Smallridge, RC, Ain, KB, Asa, SL, Bible, KC, Brierley, JD, Burman, KD et al. American Thyroid Association guidelines for management of patients with anaplastic thyroid cancer. Thyroid 2012;22:1104–39CrossRefGoogle ScholarPubMed
8Rajeev, P, Ezzat, T, Slade, M, Sadler, GP, Mihai, R. Tracheal stenting has minimal impact on survival in anaplastic thyroid carcinoma. World J Surg 2013;37:2589–93CrossRefGoogle ScholarPubMed
9Hundahl, SA, Cady, B, Cunningham, MP, Mazzaferri, E, McKee, RF, Rosai, J et al. Initial results from a prospective cohort study of 5583 cases of thyroid carcinoma treated in the United States during 1996. U.S. and German Thyroid Cancer Study Group. An American College of Surgeons Commission on Cancer Patient Care Evaluation study. Cancer 2000;89:202–173.0.CO;2-A>CrossRefGoogle Scholar
10Kebebew, E, Greenspan, FS, Clark, OH, Woeber, KA, McMillan, A. Anaplastic thyroid carcinoma. Treatment outcome and prognostic factors. Cancer 2005;103:1330–5CrossRefGoogle ScholarPubMed
11Nagaiah, G, Hossain, A, Mooney, CJ, Parmentier, J, Remick, SC. Anaplastic thyroid cancer: a review of epidemiology, pathogenesis, and treatment. J Oncol 2011;2011:542358CrossRefGoogle ScholarPubMed
12O'Neill, JP, O'Neill, B, Condron, C, Walsh, M, Bouchier-Hayes, D. Anaplastic (undifferentiated) thyroid cancer: improved insight and therapeutic strategy into a highly aggressive disease. J Laryngol Otol 2005;119:585–91CrossRefGoogle ScholarPubMed
13Shaha, AR. Airway management in anaplastic thyroid carcinoma. Laryngoscope 2008;118:1195–8CrossRefGoogle ScholarPubMed
14Tsutsui, H, Kubota, M, Yamada, M, Suzuki, A, Usuda, J, Shibuya, H et al. Airway stenting for the treatment of laryngotracheal stenosis secondary to thyroid cancer. Respirology 2008;13:632–8CrossRefGoogle ScholarPubMed
15Noppen, M, Poppe, K, D'Haese, J, Meysman, M, Velkeniers, B, Vincken, W. Interventional bronchoscopy for treatment of tracheal obstruction secondary to benign or malignant thyroid disease. Chest 2004;125:723–30CrossRefGoogle ScholarPubMed
16Ribechini, A, Bottici, V, Chella, A, Elisei, R, Vitti, P, Pinchera, A et al. Interventional bronchoscopy in the treatment of tracheal obstruction secondary to advanced thyroid cancer. J Endocrinol Invest 2006;29:131–5CrossRefGoogle ScholarPubMed
17Hopkins, C, Stearns, M, Watkinson, AF. Palliative tracheal stenting in invasive papillary thyroid carcinoma. J Laryngol Otol 2001;115:935–7CrossRefGoogle ScholarPubMed
18Wassermann, K, Koch, A, Müller-Ehmsen, J, Reuter, M, Michel, O, Eckel, HE. Clinical and laboratory evaluation of a new thin-walled self-expanding tracheobronchial silicone stent: progress and pitfalls. J Thorac Cardiovasc Surg 1997;114:527–34CrossRefGoogle ScholarPubMed
19Bolliger, CT, Probst, R, Tschopp, K, Solèr, M, Perruchoud, AP. Silicone stents in the management of inoperable tracheobronchial stenoses. Indications and limitations. Chest 1993;104:1653–9CrossRefGoogle ScholarPubMed
20Wood, DE, Liu, YH, Vallières, E, Karmy-Jones, R, Mulligan, MS. Airway stenting for malignant and benign tracheobronchial stenosis. Ann Thorac Surg 2003;76:167–72CrossRefGoogle ScholarPubMed
21Gunasekaran, S, Osborn, JR, Morgan, A, Griffiths, MV. Tracheal stenting: a better method of dealing with airway obstruction due to thyroid malignancies than tracheostomy. J Laryngol Otol 2004;118:462–4CrossRefGoogle ScholarPubMed
22Madden, B, Datta, S, Charokopos, N. Experience with Ultraflex expandable metallic stents in the management of endobronchial pathology. Ann Thorac Surg 2002;73:938–44CrossRefGoogle ScholarPubMed
23Gaafar, AH, Shaaban, AY, Elhadidi, MS. The use of metallic expandable tracheal stents in the management of inoperable malignant tracheal obstruction. Eur Arch Otorhinolaryngol 2012;269:247–53CrossRefGoogle ScholarPubMed
24Madden, BP, Loke, TK, Sheth, AC. Do expandable metallic airway stents have a role in the management of patients with benign tracheobronchial disease? Ann Thorac Surg 2006;82:274–8CrossRefGoogle ScholarPubMed
25Bacon, JL, Leaver, SK, Madden, B. Pleural disease. P200 six year experience with rigid bronchoscopy: complications, indications and changing referral patterns. Thorax 2012;67(suppl 2):A151–2CrossRefGoogle Scholar
26Remacle, M, Lawson, G, Jamart, J, Keghian, J. Progressive experience in tracheal stenting with self-expandable stents. Eur Arch Otorhinolaryngol 2003;260:369–73CrossRefGoogle ScholarPubMed