A Meta Analysis to Identify the Extent of Thyroidectomy in Advanced Cancer Larynx

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 systematic review and meta-analysis aimed to assess the incidence of thyroid invasion in patients with advanced laryngeal cancer and identify risk factors for thyroid invasion to clarify the indications for thyroidectomy. The study also sought to reduce the incidence of postoperative hypothyroidism and provide guidance for individualized treatment approaches. Patients and Methods A comprehensive search was conducted, and six studies involving a total of 852 patients were included in the meta- analysis. 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%. The overall incidence of thyroid invasion among patients undergoing total laryngectomy was 13.3%. Subglottic tumor site and T4 classification were identified as significant risk factors for thyroid invasion, while supra glottis and glottis tumor sites, as well as 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 supra glottis or glottis tumor sites and T3 classification, the thyroid gland may be preserved to reduce the risk of postoperative hypothyroidism. Further research is warranted to refine the surgical indications for thyroidectomy in patients with advanced laryngeal cancer.