Segmental Tracheal Resection for Thyroid Cancer: Perioperative Morbidity, Locoregional Control, and Survival.

Abstract

Segmental tracheal resection is rarely needed for advanced thyroid cancer but is among the most complex, high-risk thyroid surgeries. Retrospective study of patients undergoing segmental tracheal resection for thyroid cancer at MD Anderson Cancer Center (2005-2024). We identified 120 patients with a median follow-up of 4.6 years (range 0.02-16.38). Papillary thyroid cancer was most common (68%). The median number of tracheal rings resected was 4 (range 1-9). Seventeen (14%) patients had a new tracheostomy placed at the time of surgery, with 11 (9%) remaining trach-dependent at last follow-up. Twenty-six (22%) patients had a return to the operating room within 30 days, while 3 (3%) patients suffered perioperative mortality. The more common postoperative complications included tracheostomy tube placement (10%), hematoma (7%), and anastomotic air leak (6%). Median hospitalization was 6 days (range 2-67). Locoregional control (LRC) and overall survival (OS) were 79% and 77% at 5 years, respectively. Segmental tracheal resection for advanced thyroid cancer is technically complex and high-risk, but most patients stay recurrence-free 5 years post-surgery.