Anaplastic (undifferentiated) thyroid carcinoma (ATC). A retrospective analysis

Area of Science:

• Oncology
• Surgical Oncology
• Thyroid Cancer Research

Background:

• Anaplastic thyroid carcinoma (ATC) often presents with poor prognosis due to advanced stage and patient condition.
• Previous beliefs suggested limited surgical intervention beyond diagnosis confirmation for ATC.
• However, ultraradical surgery was sometimes considered to enhance survival and quality of life.

Purpose of the Study:

• To evaluate the impact of restricted radical surgery versus ultraradical approaches in anaplastic thyroid carcinoma.
• To determine prognostic factors influencing survival in ATC patients undergoing surgery.

Main Methods:

• Retrospective analysis of 120 patients with anaplastic thyroid carcinoma.
• Focus on restricted radical surgery: maximal tumor excision, avoiding resection of vital organs (esophagus, larynx, trachea).
• Comparison of outcomes based on the extent of surgical resection and presence of tumor residues.

Main Results:

• Overall 5-year survival was 6±2%, with a median survival of 3.1 months.
• Complete tumor resection (R0) significantly improved prognosis (15±5% 5-year survival) compared to residual tumor (R1/R2) (no 5-year survivors).
• Tumor morphology, differentiated components, and lymph node involvement did not significantly impact prognosis.

Conclusions:

• The primary surgical goal in ATC should be maximal tumor removal (thyroidectomy) and, if feasible, neck dissection (restricted radical approach).
• Ultraradical surgery involving segmental resection of the larynx, trachea, or esophagus is not indicated due to questionable survival benefits and diminished quality of life.
• Restricted radical surgery can improve quality of life for anaplastic thyroid carcinoma patients.