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Anaplastic thyroid carcinoma: a 25-year single-institution experience
A Mohebati1, M Dilorenzo, F Palmer
1Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Annals of Surgical Oncology
|February 21, 2014
Summary
Anaplastic thyroid carcinoma (ATC) survival is poor, but aggressive treatment improves outcomes. Multimodality therapy including surgery and radiation offers the best chance for patients with limited disease.
Area of Science:
- Oncology
- Thyroid Cancer Research
- Surgical Oncology
Background:
- Anaplastic thyroid carcinoma (ATC) is a rare and aggressive thyroid malignancy.
- ATC accounts for 1-5% of all thyroid cancers.
- Limited data exists on prognostic factors and optimal treatment for ATC.
Purpose of the Study:
- To evaluate prognostic factors, treatment strategies, and patient outcomes in ATC.
- To identify predictors of survival in ATC patients.
- To analyze treatment approaches at a single institution.
Main Methods:
- Retrospective review of 83 ATC patients diagnosed between 1985 and 2010.
- Analysis of patient, tumor, and treatment characteristics.
- Kaplan-Meier method for disease-specific survival (DSS) and univariate/multivariate analyses for prognostic factors.
Main Results:
- Median survival was 8 months, with 1- and 2-year DSS of 33% and 23%, respectively.
- Younger age, N0 neck, absence of extrathyroidal extension (ETE), gross total resection, and multimodality treatment predicted improved survival.
- Multivariate analysis identified absence of cETE, gross total resection, and multimodality therapy as significant predictors of better outcomes.
Conclusions:
- Multimodality treatment, including gross total resection and postoperative radiotherapy, improves local control and DSS in locoregional limited ATC.
- Aggressive surgical and adjuvant therapies are crucial for improving outcomes in anaplastic thyroid carcinoma.
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