Predictive factors and clinicopathological characteristics of outcome in poorly differentiated thyroid carcinoma: a single-institution study

Abstract

ObjectiveTo elucidate the clinicopathological characteristics and prognostic factors of poorly differentiated thyroid carcinoma.MethodA total of 24912 thyroid carcinoma patients admitted to the First Medical Center of Chinese People’s Liberation Army General Hospital from 2005 to 2020 were retrospectively reviewed. A total of 94 patients (39 males and 55 females, a male-female ratio of 1:1.4) fulfilled the selection criteria. Of these, 73 patients had undergone surgery. The clinical and pathological data were collected from each enrolled patient. Univariate and multivariate Cox regression analyses were performed to determine independent prognostic factors. All analyses were performed with the SPSS version 26.0 and R version 1.2.5033 in the R Studio environment.ResultsThe specimens included 20 cases of poorly differentiated thyroid carcinoma complicated with papillary thyroid carcinoma, 17 cases complicated with follicular thyroid carcinoma, 34 cases complicated with other pathological types and 23 with a separate entity. The patient demonstrated a large age span, median age was 57 years (range 8–85 years, average 55.20 ± 15.74 years). The survival time of the 94 cases was calculated, and the mean Overall survival time was 33 (range, 1-170) months, and the mean Recurrence-free survival time was 14 (range, 1-90) months. Recurrence-free mortality is related to the age at diagnosis, extrathyroidal extension and Associated thyroid cancer (p<0.05). In contrast, overall mortality is related to the age at diagnosis, sex, extrathyroidal extension, T stage (AJCC 8th), surgery and radiation (p<0.05).ConclusionMiddle-aged and elderly patients are still at high risk for poorly differentiated thyroid carcinoma. The pathologic results of poorly differentiated thyroid carcinoma are varied, and reasonable treatment has an important impact on the prognosis of poorly differentiated thyroid carcinoma.

The Long Journey towards Personalized Targeted Therapy in Poorly Differentiated Thyroid Carcinoma (PDTC): A Case Report and Systematic Review

“…In our case report, RAIR disease was evident after two RAI treatments. External beam radiation therapy (EBRT) is a viable option for controlling local disease in patients with PDTC and was utilized in the subset of patients with unresected, locally advanced disease or with metastatic foci such as bone lesions [ 42 , 49 , 50 , 58 , 60 , 61 , 62 , 63 , 64 , 67 , 68 , 69 , 70 , 74 , 75 , 80 , 81 , 85 , 90 , 91 , 97 , 98 , 102 , 106 , 107 , 108 , 109 , 112 , 113 , 116 ].…”

“…However, it remains debatable whether the cut-off value for the poorly differentiated area should be reported in PDTC tumors. Based on our review, several cases had a multiconstituent histology of well-differentiated (mostly PTC and FTC) with poorly differentiated areas without elaborating on their extent [ 49 , 50 , 55 , 56 , 58 , 69 , 71 , 72 , 73 , 91 , 100 , 103 , 107 , 109 , 112 , 113 ]. Interestingly, the Japanese society of thyroid surgery emphasizes that the presence of a poorly differentiated component should be acknowledged as a distinct entity from DTC, independent of its histological extent within the tumor [ 128 ].…”

“…In the majority of studies in our review, the extent of the poorly differentiated area was not reported, and a PDTC definition was decided to address this component. A large number of patients with PDTC reviewed herein presented with locally advanced disease (T3 or T4, extrathyroidal extension, and nodal involvement) [ 40 , 44 , 46 , 47 , 49 , 50 , 51 , 54 , 55 , 57 , 58 , 60 , 61 , 62 , 64 , 67 , 68 , 69 , 70 , 71 , 73 , 74 , 75 , 76 , 77 , 78 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 90 , 91 , 92 , 94 , 97 , 98 , 99 , 100 , 101 , 102 , 107 , 108 , 109 , 111 , 112 , 113 , 114 , 115 , 116 ,…”

“…Furthermore, since the majority of the studies did not report the exact percentage of the PDTC component in DTC, we decided to include any relevant study with any component of poorly differentiated area in the pathology review. Additionally, despite the exclusion of pediatric populations, we decided to include a few cohort studies that also included, among others, minor patients [ 54 , 58 , 74 , 91 , 112 , 113 ], since they could shed light on the characteristics of PDTC in a wider population.…”

Drug repositioning in thyroid cancer: from point mutations to gene fusions

“…The most prevalent is papillary thyroid cancer (PTC), which accounts for up to 85% and has a good prognosis (5-year survival rate of more than 95%, mainly in patients with stage I or II disease), as does follicular thyroid cancer (FTC), which is less prevalent, accounting for 15% of all cases ( 4 ). Patients with poorly differentiated or anaplastic TC, advanced-stage disease, or distant metastases have higher mortality rates ( 5 ). Moreover, about 20% of PTC patients manifest disease recurrence because of drug resistance, suggesting a change in treatment approaches.…”