Document Detail

Treatment outcomes in anaplastic thyroid carcinoma: survival improvement in young patients with localized disease treated by combination of surgery and radiotherapy.
MedLine Citation:
PMID:  18581185     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Anaplastic thyroid carcinoma (ATC) is a notoriously aggressive malignancy associated with a highly lethal clinical course despite therapeutic intervention. Our present study attempts to identify factors that could potentially improve therapeutic strategies by analyzing the clinicopathological features, treatment and outcome of ATC patients managed over the past four decades at our institution. METHODS: Fifty patients with biopsy-proven ATC during the period 1966 to 2006 were studied. All patients were managed with surgery, radiotherapy, chemotherapy and/or chemoradiation. Survival was calculated by the Kaplan-Meier method. Potential factors affecting survival were compared by the log rank test. RESULTS: Most patients (88%) presented with a neck mass; 17 patients (34%) also had cervical lymphadenopathy. Distant metastases were clinically present in 9 (18%). Median survival was 97 days, whereas the 1- and 3-year survival was 14% and 8%, respectively. On univariate analysis, patients aged </=65 years (P = .04), absence of metastatic disease at presentation (P < .01), surgical resection (P < .01), and postoperative radiotherapy (P < .01) were associated with longer survival. The adoption of cytotoxic chemotherapy was not associated with better survival (P = .4). Moreover, there was no improvement in survival rate over the last four decades despite the adoption of multimodal treatment (P = .5). CONCLUSION: ATC remains a deadly disease despite technical advances in surgical technique and adoption of multidisciplinary treatment strategies over the last four decades. However, younger patients with localized ATC might benefit from an aggressive multidisciplinary approach.
Thomas Yau; C Y Lo; R J Epstein; A K Y Lam; K Y Wan; Brian H Lang
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Publication Detail:
Type:  Journal Article     Date:  2008-06-26
Journal Detail:
Title:  Annals of surgical oncology     Volume:  15     ISSN:  1534-4681     ISO Abbreviation:  Ann. Surg. Oncol.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-20     Completed Date:  2008-10-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9420840     Medline TA:  Ann Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2500-5     Citation Subset:  IM    
Department of Medicine, University of Hong Kong Medical Centre, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China.
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MeSH Terms
Aged, 80 and over
Carcinoma / mortality*,  pathology,  radiotherapy,  surgery,  therapy*
Combined Modality Therapy
Lymphatic Metastasis
Middle Aged
Survival Rate
Thyroid Neoplasms / mortality*,  pathology,  radiotherapy,  surgery,  therapy*
Treatment Outcome

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