Anaplastic thyroid cancer, tumorigenesis and therapy

O’Neill, James Paul; Power, Derek G.; Condron, Claire; Bouchier‐Hayes, David; Walsh, Michael

doi:10.1007/s11845-009-0364-y

Cited by 23 publications

(15 citation statements)

References 54 publications

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“…The overall five-year survival rate of patients with thyroid cancer is about 97.9% [2]. However, while anaplastic TC accounts for only 2% of all the cases, 50% of the deaths are from this malignancy annually and the remainder due to aggressive variants of metastatic papillary and follicular TCs which have higher risk of recurrence, shortened disease free survival and death [3, 4]. The localized differentiated thyroid cancer (DTC) is managed by surgery and radioiodine therapy; about 10% of these patients develop progressive invasive primary disease and 5% have distant metastases.…”

Section: Introductionmentioning

confidence: 99%

Programmed death-ligand 1 overexpression is a prognostic marker for aggressive papillary thyroid cancer and its variants

et al. 2016

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Programmed death-ligand 1(PD-L1) expression on tumor cells is emerging as a potential predictive biomarker in anti-PD-L1 directed cancer immunotherapy. We analyzed PD-L1 expression in papillary thyroid carcinoma (PTC) and its variants and determined its prognostic potential to predict clinical outcome in these patients. This study was conducted at an academic oncology hospital which is a prime referral centre for thyroid diseases. Immunohistochemical subcellular localization (IHC) analyses of PD-L1 protein was retrospectively performed on 251 archived formalin fixed and paraffin embedded (FFPE) surgical tissues (66 benign thyroid nodules and 185 PTCs) using a rabbit monoclonal anti-PD-L1 antibody (E1L3N, Cell Signaling Technology) and detected using VECTASTAIN rapid protocol with diaminobenzidine (DAB) as the chromogen. The clinical-pathological factors and disease outcome over 190 months were assessed; immunohistochemical subcellular localization of PD-L1 was correlated with disease free survival (DFS) using Kaplan Meier survival and Cox multivariate regression analysis. Increased PD-L1 immunostaining was predominantly localized in cytoplasm and occasionally in plasma membrane of tumor cells. Among all combined stages of PTC, patients with increased PD-L1 membrane or cytoplasmic positivity had significantly shorter median DFS (36 months and 49 months respectively) as compared to those with PD-L1 negative tumors (DFS, both 186 months with p < 0.001 and p < 0.01 respectively). Comparison of PD-L1+ and PD-L1− patients with matched staging showed increased cytoplasmic positivity in all four stages of PTC that correlated with a greater risk of recurrence and a poor prognosis, but increased membrane positivity significantly correlated with a greater risk of metastasis or death only in Stage IV patients. In conclusion, PD-L1 positive expression in PTC correlates with a greater risk of recurrence and shortened disease free survival supporting its potential application as a prognostic marker for PTC.

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Section: Introductionmentioning

confidence: 99%

Programmed death-ligand 1 overexpression is a prognostic marker for aggressive papillary thyroid cancer and its variants

et al. 2016

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“…Such cases attest to the need for more fundamental prognostic markers in evaluating and treating ATC patients. ATC pathogenesis stems from a complex array of genetic derangements, including gene mutations and amplifications [2, 3, 14, 15]. We speculate that the genetic alterations (or lack thereof) underlying our case contribute to its unique outcome.…”

Section: Discussionmentioning

confidence: 92%

“…ATC is a rare but extremely aggressive and rapidly lethal thyroid cancer derived from follicular epithelial thyroid cells; in fact, it is one of the most deadly human cancers [2, 3]. Although this cancer accounts for only about 2% of all thyroid malignancies, it is responsible for nearly half of thyroid-cancer-related human deaths in the United States [4].…”

Section: Discussionmentioning

confidence: 99%

“…Given the lack of effective medical treatment for ATC currently, aggressive multimodal treatment customized on a case-by-case basis, particularly after early diagnosis, remains the treatment of choice for this cancer [2, 3, 16, 17]. When this patient was seen by the medical endocrine team at our institution, he was immediately referred and arranged for surgical, medical oncology, and radiation oncology consults.…”

Section: Discussionmentioning

confidence: 99%

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A Large Nonmetastatic Anaplastic Thyroid Cancer with Complete Thyroidal Confinement

Xing

Bishop

Mathioudakis

et al. 2011

Case Reports in Medicine

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Anaplastic thyroid cancer (ATC) is rare but extremely aggressive, which accounts for about 2% of all thyroid cancers yet nearly 50% of thyroid-cancer-associated deaths in the United States. The median survival time from diagnosis is 5 months, with a 1-year survival rate of only 20%. We report here a case of ATC in a 56-year-old man who survived a large ATC. Preoperative fine-needle aspiration biopsy study to a large right thyroid mass suggested ATC. Total thyroidectomy with radical lateral neck and central neck dissection removed a well-circumscribed 9.5 cm tumor without extrathyroidal extension or lymphovascular invasion. All 73 lymph nodes removed were negative for metastasis. The tumor consisted of highly pleomorphic, undifferentiated cells with large zones of necrosis and loss of thyroid transcription factor-1 and thyroglobulin expression. A focal well-differentiated component and PAX8 expression confirmed its thyroid follicular cell origin. Nine months after postsurgical adjuvant concurrent radiation therapy and chemotherapy, the patient remained well without clinical, biochemical, and radiographical evidence for cancer recurrence. This is an unusual case of ATC in that it is one of the largest ATC tumors reported to display mild pathologic behavior and relatively long-term patient survival.

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“…Because the expression of NIS is decreased in ATC, ATC does not accumulate I-131 and therefore is refractory to RAI therapy. 20,21) However, if the patients had thyroid cancer which contained only small component of intrathyroidal ATC and was completely resected, RAI therapy may be considered for ablation of PTC. 22) In previous study, both RAI and RT were effective for the improvement of survival of DTC with anaplastic foci and showed no significant difference.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Prognosis of Differentiated Thyroid Carcinoma with Small Foci of Anaplastic Transformation

et al. 2017

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Background and Objectives: Anaplastic thyroid carcinoma (ATC) is commonly related with concurrent differentiated thyroid carcinoma (DTC). We aimed to examine the clinicopathologic characteristics, prognosis and gene expression of DTC with anaplastic foci. Materials and Methods: Eighteen patients with DTC with anaplastic foci were enrolled in this study. To compare the clinicopathologic characteristics and prognosis of anaplastic foci subjects with conventional ATC or DTC, we additionally included 12 ATC and 1030 DTC patients who diagnosed during same period. Immunohistochemistry was performed to check the gene expression in anaplastic foci and DTC component. Results: In anaplastic foci group, tumor size was larger (2.5±1.3 vs. 1.2±0.9 cm, p=0.001), distant metastasis was more frequent (11.1 vs. 0%, p=0.000) and 1-year survival rate was low (88.9 vs. 100%, p=0.000) than DTC group. In contrast, compared with ATC group, anaplastic foci group showed younger age at diagnosis (50±16 vs. 63±18 years, p=0.039), smaller tumor size (2.5±1.3 vs. 3.8±1.4 cm, p=0.027), less distant metastasis (11.1 vs. 41.7%, p=0.084) and longer 1-year survival rate (88.9 vs. 25.0%, p=0.001). Expression of p53 protein was observed in 100% of anaplastic foci, ATC and 12.5% of papillary thyroid carcinoma component. Conclusion: DTC with foci of anaplastic transformation has a worse prognosis than DTC, but a better prognosis than ATC. Our results support that DTC with anaplastic foci was intermediate state from DTC to ATC.

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Anaplastic thyroid cancer, tumorigenesis and therapy

Cited by 23 publications

References 54 publications

Programmed death-ligand 1 overexpression is a prognostic marker for aggressive papillary thyroid cancer and its variants

Programmed death-ligand 1 overexpression is a prognostic marker for aggressive papillary thyroid cancer and its variants

A Large Nonmetastatic Anaplastic Thyroid Cancer with Complete Thyroidal Confinement

Clinical Characteristics and Prognosis of Differentiated Thyroid Carcinoma with Small Foci of Anaplastic Transformation

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