The Application of Bronchoscopic Modalities for Trachea Invasion by Thyroid Cancer_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

ChenLong , HuangHaidong , DongYuchao , ZhangWei , WangQing , YaoXiaopeng ,  BaiChong , LiQiang

Department of Respiratory and Critical Care Medicine, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China;

Corresponding?author：

BaiChong, Email: bc7878@sohu.com

Keywords：

Thyroid cancer; Trachea invasion; Brochoscopy; Therapy

DOI：

10.7507/1671-6205.2016062

Video：

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Objective To assess the efficiency, safety and long-term prognosis for interventional bronchoscopy in the treatment of trachea invasion by thyroid cancer. Methods The clinical data of forty-three patients with trachea invasion by thyroid cancer in Changhai Hospital from January 2006 to September 2015 were retrospectively analyzed. The trachea diameter and dyspnea score were compared before and after interventional treatment to explore the efficiency. The complications during and after therapy were observed. All patients were treated with interventional modalities including electrocautery, argon plasma coagulation, laser, cryotherapy, stent insertion or radioactive seeds implantation according to different invasion types, degree of stenosis and base situation. Results The trachea diameter increased from (3.9±1.5)mm to (10.6±0.6)mm after bronchoscopy therapy (t=-17.314, P < 0.000 1). The dyspnea score decreased from 3.3±0.7 to 2.3±0.7 after bronchoscopy therapy (t=9.274, P < 0.000 1). The complications during therapy included haemorrhage (46.5%), vocal cord paralysis (4.7%) and glottis edema (7.0%). The restenosis rate in the patients with stent insertion was 26.7%. Thirty-seven patients were followed up successfully, and the medium survival time for follow-up patients was 27 months. The univariate and multivariate analysis indicated that the kind of interventional modalities used for therapy was an independent prognostic factor of survival (HR=0.261, P=0.036). The medium survival time for the patients treated with≥3 methods, 2 methods and 1 method was 47 months, 36 months and 13 months, respectively. Conclusions For trachea invasion by thyroid cancer, bronchoscopic therapy can effectively relieve airway obstruction and dyspnea symptom. Combination of multiple interventional modalities could have a favorable prognosis after treatment.

Citation： Chen Long, Huang Haidong, Dong Yuchao, Zhang Wei, Wang Qing, Yao Xiaopeng, Bai Chong, Li Qiang. The Application of Bronchoscopic Modalities for Trachea Invasion by Thyroid Cancer. Chinese Journal of Respiratory and Critical Care Medicine, 2016, 15(3): 266-270. doi: 10.7507/1671-6205.2016062 Copy

1.	Wang H, Tao M, Zhang N, et al. Bronchoscopic interventions combined with percutaneous modalities for the treatment of thyroid cancers with airway invasion. Eur Arch Otorhinolaryngol, 2015, 272: 445-451.
2.	Ribechini A, Bottici V, Chella A, et al. Interventional bronchoscopy in the treatment of tracheal obstruction secondary to advanced thyroid cancer. J Endocrinol Invest, 2006, 29:131-135.
3.	徐新博, 李文明, 金童, 等.分化型甲狀腺癌累及喉氣管的外科治療.臨床耳鼻咽喉頭頸外科雜志, 2014, 28:1934-1937.
4.	Gaissert HA, Honings J, Grillo HC, et al. Segmental laryngotracheal and tracheal resection for invasive thyroid carcinoma. Annals Thorac Surg, 2007, 83:1952-1959.
5.	Ali MZ, Muzafar S, Umair B, et al. Tracheal resection and end-to-end anastomosis for tracheal stenosis: etiology and outcome. Acta Oto-laryngol, 2011, 129:575-579.
6.	Yang R, Yu X, Ma L, et al. Emergency management of a patient with severe airway obstruction resulting from poorly differentiated thyroid carcinoma: a case report. Oncol Lett, 2012, 4:771-774.
7.	Stephens KE, Wood DE. Bronchoscopic management of central airway obstruction. J Thorac Cardiovascular Surg, 2000, 119:289-296.
8.	Koike E, Yamashita H, Noguchi S, et al. Bronchoscopic diagnosis of thyroid cancer with laryngotracheal invasion. Arch Surg, 2001, 136:1185-1189.
9.	Stubarg R, Adams L. Textbook of respiratory medicine. Philadelphia: Saunders, 1994, 511-512.
10.	Koshiishi H, Toriya K, Ozaki O, et al. Fiberoptic bronchoscopy in thyroid carcinoma with tracheal invasion. Diagn Ther Endosc, 1998, 4:113-118.
11.	童林榮, 白沖.經支氣管鏡高頻電圈套治療氣道新生物的臨床應用.臨床肺科雜志, 2014, 19:1579-1581.
12.	Tsutsui H, Kubota M, Yamada M, et al. Airway stenting for the treatment of laryngotracheal stenosis secondary to thyroid cancer. Respirology, 2008, 13:632-638.
13.	Bolliger CT, Mathur PN. Interventional bronchoscopy. Vol.20.Basel:Karger Medical and Scientific Publishers, 2000, 133-145.
14.	Jiang JH, Turner JF, Huang JA. Endobronchial ultrasound elastography: a new method in endobronchial ultrasound-guided transbronchial needle aspiration. J Thorac Dis, 2015, 7:S272.
15.	史小武, 楊鋼, 趙蘇, 等.氣道支架治療甲狀腺癌所致氣管狹窄的臨床觀察.中華內分泌外科雜志, 2013, 7:295-298.
16.	Yuasa R, Hata Y, Otsuka H, et al. Placement of self-expandable metallic stents for tracheal stenosis secondary to thyroid cancer. Mol Clin Oncol, 2014, 2:1003-1008.
17.	Bolliger CT, Sutedja TG, Strausz J, et al. Therapeutic bronchoscopy with immediate effect: laser, electrocautery, argon plasma coagulation and stents. Eur Respir J, 2006, 27:1258-1271.
18.	Coulter TD, Mehta AC. The heat is on: impact of endobronchial electrosurgery on the need for Nd-YAG laser photoresection. Chest, 2000, 118:516-521.
19.	Noppen M, Poppe K, D'haese J, et al. Interventional bronchoscopy for treatment of tracheal obstruction secondary to benign or malignant thyroid disease. Chest, 2004, 125:723-730.
20.	Bai C, Dong YC, Song XL, et al. In vitro study of safety and co-efficiency of the transbronchial coagulation techniques. Chin Med J, 2013, 126:124-128.
21.	Rand IA, Barber PV, Goldring J, et al. British Thoracic Society guideline for advanced diagnostic and therapeutic flexible bronchoscopy in adults. Thorax, 2011, 66:1-21.
22.	王洪武, 周云芝, 羅凌飛, 等.氣管鏡微創治療結合放/化療粒子植入治療侵犯氣管壁的甲狀腺乳頭狀癌.中國肺癌雜志, 2009, 12:831-834.

1. Wang H, Tao M, Zhang N, et al. Bronchoscopic interventions combined with percutaneous modalities for the treatment of thyroid cancers with airway invasion. Eur Arch Otorhinolaryngol, 2015, 272: 445-451.
2. Ribechini A, Bottici V, Chella A, et al. Interventional bronchoscopy in the treatment of tracheal obstruction secondary to advanced thyroid cancer. J Endocrinol Invest, 2006, 29:131-135.
3. 徐新博, 李文明, 金童, 等.分化型甲狀腺癌累及喉氣管的外科治療.臨床耳鼻咽喉頭頸外科雜志, 2014, 28:1934-1937.
4. Gaissert HA, Honings J, Grillo HC, et al. Segmental laryngotracheal and tracheal resection for invasive thyroid carcinoma. Annals Thorac Surg, 2007, 83:1952-1959.
5. Ali MZ, Muzafar S, Umair B, et al. Tracheal resection and end-to-end anastomosis for tracheal stenosis: etiology and outcome. Acta Oto-laryngol, 2011, 129:575-579.
6. Yang R, Yu X, Ma L, et al. Emergency management of a patient with severe airway obstruction resulting from poorly differentiated thyroid carcinoma: a case report. Oncol Lett, 2012, 4:771-774.
7. Stephens KE, Wood DE. Bronchoscopic management of central airway obstruction. J Thorac Cardiovascular Surg, 2000, 119:289-296.
8. Koike E, Yamashita H, Noguchi S, et al. Bronchoscopic diagnosis of thyroid cancer with laryngotracheal invasion. Arch Surg, 2001, 136:1185-1189.
9. Stubarg R, Adams L. Textbook of respiratory medicine. Philadelphia: Saunders, 1994, 511-512.
10. Koshiishi H, Toriya K, Ozaki O, et al. Fiberoptic bronchoscopy in thyroid carcinoma with tracheal invasion. Diagn Ther Endosc, 1998, 4:113-118.
11. 童林榮, 白沖.經支氣管鏡高頻電圈套治療氣道新生物的臨床應用.臨床肺科雜志, 2014, 19:1579-1581.
12. Tsutsui H, Kubota M, Yamada M, et al. Airway stenting for the treatment of laryngotracheal stenosis secondary to thyroid cancer. Respirology, 2008, 13:632-638.
13. Bolliger CT, Mathur PN. Interventional bronchoscopy. Vol.20.Basel:Karger Medical and Scientific Publishers, 2000, 133-145.
14. Jiang JH, Turner JF, Huang JA. Endobronchial ultrasound elastography: a new method in endobronchial ultrasound-guided transbronchial needle aspiration. J Thorac Dis, 2015, 7:S272.
15. 史小武, 楊鋼, 趙蘇, 等.氣道支架治療甲狀腺癌所致氣管狹窄的臨床觀察.中華內分泌外科雜志, 2013, 7:295-298.
16. Yuasa R, Hata Y, Otsuka H, et al. Placement of self-expandable metallic stents for tracheal stenosis secondary to thyroid cancer. Mol Clin Oncol, 2014, 2:1003-1008.
17. Bolliger CT, Sutedja TG, Strausz J, et al. Therapeutic bronchoscopy with immediate effect: laser, electrocautery, argon plasma coagulation and stents. Eur Respir J, 2006, 27:1258-1271.
18. Coulter TD, Mehta AC. The heat is on: impact of endobronchial electrosurgery on the need for Nd-YAG laser photoresection. Chest, 2000, 118:516-521.
19. Noppen M, Poppe K, D'haese J, et al. Interventional bronchoscopy for treatment of tracheal obstruction secondary to benign or malignant thyroid disease. Chest, 2004, 125:723-730.
20. Bai C, Dong YC, Song XL, et al. In vitro study of safety and co-efficiency of the transbronchial coagulation techniques. Chin Med J, 2013, 126:124-128.
21. Rand IA, Barber PV, Goldring J, et al. British Thoracic Society guideline for advanced diagnostic and therapeutic flexible bronchoscopy in adults. Thorax, 2011, 66:1-21.
22. 王洪武, 周云芝, 羅凌飛, 等.氣管鏡微創治療結合放/化療粒子植入治療侵犯氣管壁的甲狀腺乳頭狀癌.中國肺癌雜志, 2009, 12:831-834.

Chinese Journal of Respiratory and Critical Care Medicine

The Application of Bronchoscopic Modalities for Trachea Invasion by Thyroid Cancer

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