Surgical management of tracheal shaving for papillary thyroid carcinoma with tracheal invasion

Conclusion: Patients showed improved quality of life following tracheal shaving and the carcinoma was well controlled locally, as long as invasion had not progressed to the mucosal surface of the trachea. However, compared with papillary thyroid carcinoma (PTC) with no tracheal invasion, metastasis was common and invasion of organs other than the trachea was frequent, putting many patients into the high-risk group. The clinical course for such patients thus requires careful monitoring, with particular attention to metastasis to other locations. Tracheal shaving can be recommended for patients with PTC with tracheal invasion. Objectives: Macroscopically, in cases where invasion into the trachea has not reached the tracheal mucosa surface, we perform tracheal surface resection (tracheal shaving). We retrospectively investigated rates of local control, metastasis and survival in patients who had undergone tracheal shaving. Patients and methods: Subjects comprised 22 patients with PTC who underwent tracheal shaving between January 1994 and December 2005. Results: Local control was achieved in 21 patients (95%), and metastasis was seen in 6 patients (27%). With two patients dying from causes other than cancer, 5- and 10-year survival rates were 93% and 41%, respectively. The two surviving patients are still cancer-bearing.