TY - JOUR
T1 - Onset of hypothyroidism after total laryngectomy
T2 - Effects of thyroid gland surgery and preoperative and postoperative radiotherapy
AU - Plaat, Robert E
AU - van Dijk, Boukje A C
AU - Muller Kobold, Anneke C
AU - Steenbakkers, Roel J H M
AU - Links, Thera P
AU - van der Laan, Bernard F A M
AU - Plaat, Boudewijn E C
N1 - © 2019 The Authors. Head & Neck published by Wiley Periodicals, Inc.
PY - 2020/4
Y1 - 2020/4
N2 - Background: To determine time of onset and risk of hypothyroidism after total laryngectomy (TL) with and without (hemi)thyroidectomy in relation to treatment regimen, that is, preoperative radiotherapy (RT-TL), postoperative radiotherapy (TL-RT), and postoperative re-irradiation (RT-TL-RT). Methods: Retrospective review of 128 patients treated by RT-TL (51 patients), TL-RT (55 patients), and RT-TL-RT (22 patients). Risk of hypothyroidism was determined by multivariable Cox regression analysis and euthyroid survival was calculated using Kaplan-Meier method. Results: Hypothyroidism developed in 69 (54%) patients. The median onset of hypothyroidism was later (P <.01) and the risk of hypothyroidism was lower (hazard ratio 0.49; P =.014) in the TL-RT group compared to both other treatment regimens. Euthyroid survival did not differ between the treatment regimens. Two years euthyroid survival was 24% with and 61% without (hemi)thyroidectomy (P <.001). Conclusions: Patients treated with TL-RT have later onset of hypothyroidism. Higher risk for hypothyroidism is associated with salvage TL after radiotherapy and (hemi)thyroidectomy.
AB - Background: To determine time of onset and risk of hypothyroidism after total laryngectomy (TL) with and without (hemi)thyroidectomy in relation to treatment regimen, that is, preoperative radiotherapy (RT-TL), postoperative radiotherapy (TL-RT), and postoperative re-irradiation (RT-TL-RT). Methods: Retrospective review of 128 patients treated by RT-TL (51 patients), TL-RT (55 patients), and RT-TL-RT (22 patients). Risk of hypothyroidism was determined by multivariable Cox regression analysis and euthyroid survival was calculated using Kaplan-Meier method. Results: Hypothyroidism developed in 69 (54%) patients. The median onset of hypothyroidism was later (P <.01) and the risk of hypothyroidism was lower (hazard ratio 0.49; P =.014) in the TL-RT group compared to both other treatment regimens. Euthyroid survival did not differ between the treatment regimens. Two years euthyroid survival was 24% with and 61% without (hemi)thyroidectomy (P <.001). Conclusions: Patients treated with TL-RT have later onset of hypothyroidism. Higher risk for hypothyroidism is associated with salvage TL after radiotherapy and (hemi)thyroidectomy.
KW - hemithyroidectomy
KW - hypothyroidism
KW - radiotherapy
KW - total laryngectomy
U2 - 10.1002/hed.26048
DO - 10.1002/hed.26048
M3 - Article
C2 - 31833166
SN - 1043-3074
VL - 42
SP - 636
EP - 644
JO - Head and Neck: Journal of the Sciences and Specialties of the Head and Neck
JF - Head and Neck: Journal of the Sciences and Specialties of the Head and Neck
IS - 4
ER -