Anaplastic carcinoma of the thyroid: A clinicopathologic study of 121 cases

Venkatesh, Yedatore; Ordóñez, Nelson G.; Schultz, Pamela N.; Hickey, Robert C.; Goepfert, Helmuth; Samaan, Naguib A.

doi:10.1002/1097-0142(19900715)66:2<321::aid-cncr2820660221>3.0.co;2-a

Cited by 434 publications

(293 citation statements)

References 37 publications

Supporting

Mentioning

270

Contrasting

Unclassified

Order By: Relevance

“…Papillary carcinoma accounts for 85-90% of differentiated thyroid cancers in iodide-sufficient countries (66), while the remaining epithelial thyroid cell tumors are predominantly follicular carcinomas. Anaplastic carcinoma, whose incidence has been decreasing, often arises from preexisting welldifferentiated (usually follicular) carcinoma (67).…”

Section: Epidemiological Studies Relationship Between Iodine Intake mentioning

confidence: 75%

Relevance of iodine intake as a reputed predisposing factor for thyroid cancer

Knobel

Medeiros‐Neto

2007

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

Iodine is a trace element that is essential for the synthesis of thyroid hormone. Both chronic iodine deficiency and iodine excess have been associated with hypertrophy and hyperplasia of follicular cells, attributed to excessive secretion of TSH. This may be associated to thyroid cancer risk, particularly in women. Experimental studies have documented thyroid cancer induction by elevation of endogenous TSH, although in a small number of animals. Iodine deficiency associated with carcinogenic agents and chemical mutagens will result in a higher incidence of thyroid malignancy. Inadequate low iodine intake will result in increased TSH stimulation, increased thyroid cell responsiveness to TSH, increased thyroid cell EGF-induced proliferation, decreased TGFβ 1 production and increased angiogenesis, all phenomena related to promotion of tumor growth. Epidemiological studies associating iodine intake and thyroid cancer led to controversial and conflicting results. There is no doubt that introduction of universal iodine prophylaxis in population previously in chronic iodine-deficiency leads to a changing pattern of more prevalent papillary thyroid cancer and declining of follicular thyroid cancer. Also anaplastic thyroid cancer is practically not seen after years of iodine supplementation. Iodine excess has also been indicated as a possible nutritional factor in the prevalence of differentiated thyroid cancer in Iceland, Hawaii and, more recently, in China. In conclusion: available evidence from animal experiments, epidemiological studies and iodine prophylaxis has demonstrated a shift towards a rise in papillary carcinoma, but no clear relationship between overall thyroid cancer incidence and iodine intake.

show abstract

Section: Epidemiological Studies Relationship Between Iodine Intake mentioning

confidence: 75%

Relevance of iodine intake as a reputed predisposing factor for thyroid cancer

Knobel

Medeiros‐Neto

2007

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

show abstract

“…In general, our sample confirms the previously reported sex and age distribution (4-6, 8, 13). The overall median survival of 3.9 months is in accordance with some previous reports (5,10,(24)(25)(26), whereas it appears worse than other published results (1, 2, 27). One explanation could be our more rigorous patient selection, excluding mixed forms of anaplastic and poorly differentiated tumors, as well as small anaplastic cancers of incidental finding.…”

Section: Discussionmentioning

confidence: 99%

Anaplastic thyroid carcinoma: clinical outcome of 30 consecutive patients referred to a single institution in the past 5 years

et al. 2007

View full text Add to dashboard Cite

Objective: Treatment options for anaplastic thyroid carcinoma (ATC), which is one of the most lethal human malignant tumors, include surgery, chemotherapy and radiotherapy usually combined in a multimodal approach, to improve survival and avoid death from local invasion. However, there is no standard protocol for ATC treatment and the optimal sequence within multimodal therapy is debated. We retrospectively report the clinical outcome of 30 ATC patients referred consecutively to the Oncological Endocrinology Unit of San Giovanni Battista Hospital (Turin, Italy) between 2000 and 2005. Design: Patients were treated by one of the following approaches: i) surgery followed by adjuvantcombined chemoradiotherapy; ii) neo-adjuvant chemoradiotherapy followed by surgery and adjuvant chemotherapy; or iii) chemotherapy alone. The surgical procedures were classified as 'maximal debulking' or 'palliative resection'. Maximal debulking entailed total or near-total thyroidectomy and complete resection of all gross tumor or minimal residual disease adherent to vital structures, independently of the presence or absence of distant metastases. In palliative resections, macroscopic residual disease was left in the neck. Survival of patients stratified by treatment was assessed. Results: Analysis of multivariate hazard ratios showed that maximal debulking followed by adjuvant chemoradiotherapy was the only treatment that modified survival of ATC patients (hazard ratioZ 0.23, 95% CI: 0.07-0.79), even if factors determining poor prognosis or increased surgical risk were present. Conclusions: Despite the overall grim outcome of ATC, these results justify an attempt at maximal debulking surgery, followed by adjuvant chemoradiotherapy, possibly in all ATC patients. 156 425-430 European Journal of Endocrinology

show abstract

“…Surgery, radiotherapy, or chemotherapy used alone is seldom sufficient to control the disease (Aldinger et al, 1978;Venkatesh et al, 1990), while a combination of these modalities may improve local control (Venkatesh et al, 1990;Schlumberger et al, 1991). The rationale for combining radio-and chemotherapy is that, as the toxicity of these modalities does not entirely overlap, an enhanced tumouricidal effect may be obtained (Wendt et al, 1985).…”

mentioning

confidence: 99%

Anaplastic thyroid carcinoma: three protocols combining doxorubicin, hyperfractionated radiotherapy and surgery

et al. 2002

View full text Add to dashboard Cite

Patients with anaplastic thyroid carcinoma can rarely be cured, but every effort should be made to prevent death due to suffocation. Between 1984 and 1999, 55 consecutive patients with anaplastic thyroid carcinoma were prospectively treated according to a combined regimen consisting of hyperfractionated radiotherapy, doxorubicin, and when feasible surgery. Radiotherapy was carried out for 5 days a week. The daily fraction until 1988 was 1.0 Gy×2 (A) and 1989–92 1.3 Gy×2 (B) . Thereafter 1.6 Gy×2 (C) was administered. Radiotherapy was administered to a total target dose of 46 Gy; of which 30 Gy was administered preoperatively in the first two protocols (A and B), while the whole dose was given preoperatively in the third protocol (C). The therapy was otherwise identical. Twenty mg doxorubicin was administered intravenously weekly. Surgery was possible in 40 patients. No patient failed to complete the protocol due to toxicity. In only 13 cases (24%) was death attributed to local failure. Five patients (9%) ‘had a survival’ exceeding 2 years. No signs of local recurrence were seen in 33 patients (60%); 5 out of 16 patients in Protocol A, 11 out of 17 patients in Protocol B, 17 out of 22 patients in Protocol C ( P =0.017). In the 40 patients undergoing additional surgery, no signs of local recurrence were seen in 5 out of 9 patients, 11 out of 14 patients and 17 out of 17 patients, respectively ( P =0.005). British Journal of Cancer (2002) 86 , 1848–1853. doi: 10.1038/sj.bjc.6600361 www.bjcancer.com © 2002 Cancer Research UK

show abstract

Anaplastic carcinoma of the thyroid: A clinicopathologic study of 121 cases

Cited by 434 publications

References 37 publications

Relevance of iodine intake as a reputed predisposing factor for thyroid cancer

Relevance of iodine intake as a reputed predisposing factor for thyroid cancer

Anaplastic thyroid carcinoma: clinical outcome of 30 consecutive patients referred to a single institution in the past 5 years

Anaplastic thyroid carcinoma: three protocols combining doxorubicin, hyperfractionated radiotherapy and surgery

Contact Info

Product

Resources

About