XXXX invading the airway: Diagnosis and management.

@entity5 @entity1 @entity259
INTRODUCTION: Aim of this study is to analyze outcome and the decision making process to approach airway invasion by @entity259 . METHODS: Retrospective study of 30 years experience in thyroid surgery for @entity5 invading airway. Clinical records, surgical and pathology reports have been analyzed to assess which principles and procedural details are significant to facilitate efficient diagnosis, staging and treatment. Medical therapy was not evaluated. RESULTS: Out of a consecutive series of 2165 @entity259 @entity1 , T4a @entity5 are 303. Airway invasion was found in 141 cases. Well-differentiated pattern was determined in 110 while other histology was reported in 31. Airway-related symptoms have been recorded in 111 @entity1 . Flexible bronchoscopy was performed in all @entity1 . Rapidly evolving disease or non-resectable airway was found in 105 cases. Permanent tracheotomy was performed in 43 cases, airway lumen restoration with or without stenting in 39, laryngectomy in 8, segmental airway resection and reconstruction in 28. Perioperative mortality was recorded after palliative treatment only. In resected @entity1 , completely radical surgery was not always achievable. All @entity1 with positive margin after resection underwent adjuvant treatment and showed comparable survival to radical surgery @entity1 after 5 years. Tumor relapse occurred in 8 cases (distant or locoregional). @entity1 with unresectable disease require treatment for symptoms relief but survival is poor. CONCLUSION: Although some @entity1 are currently referred with a severely advanced disease, the indication for tracheotomy, salvage procedures or supportive care has decreased over time. Resection is feasible for differentiated @entity5 with an overall good outcome.
