Is thyroidectomy mandatory in the surgical management of cancer larynx? A meta-analysis study

Abstract Background Laryngeal cancer is a prevalent malignancy in the head and neck region, often diagnosed at an advanced stage. The role of thyroidectomy in managing advanced laryngeal squamous cell carcinoma (LSCC) remains controversial due to inconsistent findings regarding the incidence and predictors of thyroid invasion. Aim of the work This meta-analysis aims to assess the incidence of thyroid invasion in patients with advanced laryngeal cancer and recognize hazard facets for thyroid invasion to elucidate the need for thyroidectomy. The study also aims to decrease the happening of postoperative hypothyroidism and supply guidance for individualized treatment approaches. Patients and methods A comprehensive search was conducted, and the meta-analysis included 6 studies encompassing 852 patients. Data regarding patient demographics, tumor characteristics, and incidence of thyroid invasion were extracted and analyzed. Results The meta-analysis revealed a mean age of 57.7 years among patients with advanced laryngeal cancer, with a male predominance of 94.6%. Thyroid invasion occurred in 13.3% of patients who underwent complete laryngectomy. Subglottic tumor site and T4 classification were identified as significant risk factors for thyroid invasion, while supraglottis and glottis tumor sites and T3 classification were associated with reduced risk. The odds ratio for thyroid invasion was highest for patients with T4 stage tumors. Conclusion Thyroidectomy during total laryngectomy should be considered for patients with subglottic tumor sites and T4 classification due to the increased risk of thyroid invasion. However, for patients with supraglottis or glottis tumor sites and T3 classification, the thyroid gland may be preserved to reduce the risk of postoperative hypothyroidism.