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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Associate Professor Katrin Brauckhoff, Haukeland University Hospital
- Second opponent: Senior Consultant Christel Hedman, Karolinska Institutet, Sweden
- Third member and chair of the evaluation committee: Professor Leiv Arne Rosseland, University of Oslo
Chair of the Defence
Associate Professor Harald Hrubos-Strøm, University of Oslo
Principal Supervisor
Professor Terje Osnes, University of Oslo
Summary
The thyroid gland may harbour benign and malignant tumours, and the incidence of thyroid cancer (TC) is low compared to the high prevalence of thyroid tumours.
Most TCs are limited to the thyroid gland and have an excellent prognosis. In case of TC invading the airway, prognosis is graver. There is a debate about which surgical technique should be selected for treatment, and important issues are the patency of the airway postoperatively, as well as morbidity and oncological outcomes. We evaluated these outcomes in TC patients treated with window resections of the trachea reconstructed with a vascularized myoperiosteal flap. We found that this technique provided a stable airway postoperatively. This technique may be associated with higher morbidity than other techniques but carried a lower risk of surgical mortality. Survival compared well with other studies.
Anaplastic TC (ATC) is rare but one of the most aggressive cancers, and with a poor prognosis. Several treatment options have shown to improve local control, which is important as it can spare the patient from death by suffocation. Since 2002, the treatment strategy for ATC in Oslo University Hospital has been hyperfractionated accelerated radiotherapy (HART) followed by thyroid surgery in eligible patients. We evaluated local control, survival and surgical morbidity in patients treated with HART with and without surgery. Our results showed that no patient died by suffocation. Preoperative HART may improve survival but at the expense of a higher frequency of postoperative complications.
We performed a prospective study on patients undergoing thyroid surgery for either benign or malignant thyroid tumours following health related quality of life (HRQoL) from pre-treatment to 12 months after surgery. Our results showed that HRQoL measured by perception of overall quality of life, and by perception of ability to engage in work, daily life, and leisure activities, was maintained in both patient groups.
Additional information
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