The role of surgery in the treatment of thyroid anaplastic carcinoma in the elderly

Polistena, Andrea; Monacelli, Massimo; Lucchini, Roberta; Triola, Roberta; Conti, Claudia; Avenia, Stefano; Rondelli, Fabio; Bugiantella, Walter; Barillaro, Ivan; Sanguinetti, Alessandro; Avenia, Nicola

doi:10.1016/j.ijsu.2014.08.347

Cited by 15 publications

(10 citation statements)

References 18 publications

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“…Therefore, a smaller diameter may indicate greater feasibility of surgery. Some scholars have reported significantly higher survival outcomes for patients with resectable tumours than those with unresectable tumours 3,18,24,25 . Sugitani et al 18 showed that the 1‐year survival rate was significantly higher for patients with resectable tumours than those with unresectable tumours (39.0% and 10.0%, respectively; p < .0001), indicating the important role of resection in ATC.…”

Section: Discussionmentioning

confidence: 99%

A relook at the 8th edition of the AJCC TNM staging system of anaplastic thyroid carcinoma: A SEER‐based study

Xiang

Wang

Sun

et al. 2020

Clinical Endocrinology

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Objective In the 8th edition American Joint Committee on Cancer (AJCC) tumour‐node‐metastasis (TNM) staging system (TNM‐8), changes have been made regarding anaplastic thyroid carcinoma (ATC) compared with the 7th edition (TNM‐7). The major changes are that anaplastic ATC now has the same T stage definitions as differentiated thyroid cancer, and new staging of IVA and IVB is implemented. However, the clinical impact of the new edition for ATC remains unclear due to scarce and conflicting data. In this study, we compared the AJCC TNM‐7 and TNM‐8 in the same group of patients. Design In this retrospective study, we included patients who were diagnosed with ATC between 2004 and 2015; data were gathered from the Surveillance, Epidemiology and End Results (SEER) database. Methods Overall survival (OS) was evaluated according to T stage and TNM stage according to the 7th and 8th editions. Kaplan–Meier and log‐rank testing was used to analyse OS. The effect of potential predictors was estimated using the Cox regression model. Results We included 669 patients in the study. The median age of the cohort was 70 years. During the follow‐up, 600 (89.7%) patients died, 528 of whom died of thyroid cancer. The TNM‐8 T staging more effectively predicted survival than the 7th edition (proportion of variation explained: 3.53% vs. 1.72%). However, the clinical stage was almost unchanged according to the TNM‐8 (proportion of variation explained: 10.69% vs. 10.73%). Conclusions The new T classification is an effective predictor of survival for patients with ATC. The results support the use of T definitions as per those of differentiated thyroid cancer. However, whether lymph node metastasis should be taken into account for defining ATC TNM staging should be reconsidered.

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Section: Discussionmentioning

confidence: 99%

A relook at the 8th edition of the AJCC TNM staging system of anaplastic thyroid carcinoma: A SEER‐based study

Xiang

Wang

Sun

et al. 2020

Clinical Endocrinology

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“…ATC accounts for 1% ~ 2% of all thyroid tumors, with the characteristics of fast progression, strong local invasion, high distant metastasis rate and so on. The tumor has a very poor prognosis, and the average survival time is approximately 6 to 8 months [ 1 , 3 , 7 , 9 ]. Multimodal therapy combining surgery, chemotherapy and radiation therapy, might achieve better results in improving survival in some patients; however, ATC has a very low cure rate even with the extremely radical treatments [ 3 , 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…The main treatment strategies of ATC are surgery, radiotherapy chemotherapy and biotherapy [ 4 – 7 , 12 ], and radical surgical treatment is still a key therapeutic method affecting the prognosis. This study showed that there was significant difference in survival rates among the radical surgical treatment group and non-surgical treatment group ( P = 0.000).…”

Section: Discussionmentioning

confidence: 99%

“…This study showed that there was significant difference in survival rates among the radical surgical treatment group and non-surgical treatment group ( P = 0.000). Some scholars found that survival outcomes were significantly higher in patients with resectable tumors than in those with unresectable tumors [ 2 , 7 , 10 , 13 ]. Sugitani’s study showed that the 1-year survival rate was found to be significantly higher in resectable tumors than that in the unresectable tumors (39.0% and 10.0%, respectively; P < 0.0001), which showed that the important role of surgical treatment in ATC [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Some studies showed that multimodal therapy combining surgery, chemotherapy and radiotherapy, might achieve better results in avoiding death from local invasion and improving survival in some patients; however, ATC has an extremely low cure rate even with the very best treatments, and treatment of ATC is mostly palliative [ 4 – 6 ]. Surgical resection with adjuvant radiation therapy and chemotherapy may prolong survival or improve quality of life, however strong evidence is needed to support this conclusion [ 7 , 8 ]. The optimal multimodal therapy policy is still debated and a standardized treatment strategy remains to be established.…”

Section: Introductionmentioning

confidence: 99%

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Treatment and Prognosis of Anaplastic Thyroid Carcinoma: A Clinical Study of 50 Cases

Liu

Xiao

et al. 2016

PLoS ONE

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IntroductionAlthough anaplastic thyroid carcinoma (ATC) is rare, it is one of the most aggressive human cancers. The optimal multimodal therapy policy of ATC is still debated, and a standardized treatment strategy remains to be established. This study aimed to evaluate the management aspect and prognosis of ATC.Materials and MethodsThe data were analyzed retrospectively for 50 patients with ATC to evaluate the clinical characters, management and factors influencing survival. Survival analysis was performed by Kaplan-Merier method and log-rank test, and multivariate analysis was performed using Cox proportional hazard model.ResultsThe 1-year and 2-year overall survival rates (OS) were 48.0% and 26.0% respectively in all patients, with the 2-year OS of 40.0% and 31.0% and 6.3% for stage IVA, IVB and IVC respectively (P <0.05). In stage IVA and IVB patients, combined surgery with radiotherapy improved overall survival, and the 2-year OS were 50.0% and 35.7% respectively in the group with combined surgery with radiotherapy and the group with surgery with only (P <0.05). Postoperative radiotherapy improved local control rate in stage IVA and IVB patients (P <0.05). However, surgery, radiotherapy or chemotherapy could not improve the survival of stage IVC patients. Multivariate analysis showed that distant metastases, surgery, radiotherapy and tumor residue could predict the prognosis.ConclusionCombined surgery and radiotherapy could improve overall survival in stage IVA and IVB patients. Patients with ATC have a bad prognosis. Distant metastases, surgery, radiotherapy and tumor residue are the most important factors affecting the prognosis.

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Malignant Thyroid Disease

Sakr

2024

Head and Neck and Endocrine Surgery

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The role of surgery in the treatment of thyroid anaplastic carcinoma in the elderly

Abstract: In elderly patients with ATC, although poor prognosis, surgery is still fundamental in the multimodality treatment with significant advantage in selected patients. Nevertheless most of elderly patients with large tumours are suitable only for palliative management.

Cited by 15 publications

References 18 publications

A relook at the 8th edition of the AJCC TNM staging system of anaplastic thyroid carcinoma: A SEER‐based study

A relook at the 8th edition of the AJCC TNM staging system of anaplastic thyroid carcinoma: A SEER‐based study

Treatment and Prognosis of Anaplastic Thyroid Carcinoma: A Clinical Study of 50 Cases

Malignant Thyroid Disease

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