Thyroid cancer: Different outcomes to chemotherapy according to tumour histology

Biganzoli, Laura; Gebbia, Vittorio; Maiorino, L.; Caraci, P.; Iirillo, A.

doi:10.1016/0959-8049(95)00415-7

Cited by 13 publications

(4 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A long remission therefore seems achievable in a limited number of patients with certain favorable factors at the time of diagnosis. These results are in line with the literature (1,3,4,6,18,19). This study focused on pretreatment prognostic factors in order to provide assistance to the initial consultation of patients with ATC.…”

Section: Discussionsupporting

confidence: 84%

Prognostic Factors and Survival Score for Patients With Anaplastic Thyroid Carcinoma: A Retrospective Study from a Regional Registry

et al. 2021

View full text Add to dashboard Cite

Background/Aim: Anaplastic thyroid carcinoma (ATC) is the least common but most lethal of thyroid cancer, despite various therapeutic options, with limited efficacy. In order to help therapeutic decision-making, the purpose of this study was to develop a new prognostic score providing survival estimates in patients with ATC. Patients and Methods: Based on a multivariate analysis of 149 retrospectively analyzed patients diagnosed with ATC from 1968 to 2017 at a referral center, a propensity score was developed. A model was generated providing survival probability at 6 months and median overall survival estimates. Results: The median survival was 96 days. The overall survival rate was 35% at 6 months, 20% at 1 year and 13% at 2 years. Stepwise Cox regression revealed that the most appropriate death prediction model included metastatic spread, tumor size and age class as explanatory variables. This model made it possible to define three categories of patients with different survival profiles. Conclusion: Distant metastasis, age and primary tumor size are strong independent factors that affect prognosis in patients with ATC. Using these significant pretreatment factors, we developed a score to predict survival in these patients with poor prognosis.Although anaplastic thyroid carcinoma (ATC) is rare, it is one of the most aggressive malignancies. This type of carcinoma accounts for 1.7% of all thyroid malignancies and one-half of all thyroid cancer deaths (1, 2). The median survival for patients with ATC is 3-6 months, and it has a 1-year survival rate of 20% (3-6). Indeed, ATC most commonly presents in elderly patients with poor performance status, making it difficult to tolerate an active therapeutic approach (7), although some patients survive for a relatively long time after aggressive treatment (8, 9). In such frail patients, aggressive treatment may worsen the quality of life and occasionally even shorten survival; therefore, the selection of patients who will benefit from such aggressive multimodal therapy seems important. Optimal ATC treatment is questionable due to lack of randomized trials; most studies validate the benefit of surgery. Although some reports questioned the benefit of radiotherapy (10), improved survival has been shown with post-operative radiotherapy (11) and radiation dose escalation was also associated with longer survival rates in selected patients with metastatic disease (12). Combined chemoradiotherapy was favored over radiation alone (13,14). However, several series reported no benefit for chemotherapy (6,15). Retrospective studies identified some prognostic factors such as age, gender, presence of acute symptoms, tumor size, multicentricity, metastatic spread, white blood cell level, blood platelet level and serum albumin level, influenced survival of patients with ATC (13,16,17). Here, we reviewed data from 149 patients with ATC in an attempt to identify subsets of patients that either would benefit best from a more aggressive treatment strategy or for whom palliative care would be mo...

show abstract

Section: Discussionsupporting

confidence: 84%

Prognostic Factors and Survival Score for Patients With Anaplastic Thyroid Carcinoma: A Retrospective Study from a Regional Registry

et al. 2021

View full text Add to dashboard Cite

show abstract

“…ATC has a high incidence of cervical lymph node metastases at the time of presentation in the range of 30-40%. 18,22,23,33,39 However, since the tumor tends to invade into surrounding lymph nodes forming a matted mass rather than to metastasize, the actual incidence of cervical lymph node metastases could be much higher. 34,40 The presence of cervical lymph node metastases in ATC has not been shown to affect survival possibly because of the predominance of other prognostic factors.…”

Section: The Need For Concomitant Lymph Node Dissectionmentioning

confidence: 99%

Surgical Options in Undifferentiated Thyroid Carcinoma

Lang

2007

World j. surg.

View full text Add to dashboard Cite

Undifferentiated or anaplastic carcinoma is an uncommon histologic type of thyroid cancer. It is one of the most aggressive malignancies associated with a poor prognosis. Most patients are elderly presenting as locally advanced disease with nodal and distant metastases. Complete surgical resection is frequently not possible and there is no effective systemic therapy. Aggressive multimodal therapy including surgery, radiation, and chemotherapy is recommended for management. However, because of the rarity of the disease, its aggressiveness and the lack of prospective treatment protocols, nearly all evidence in the literature comes from retrospective case series or cohort studies for selected patients' subgroups treated over a relatively long study period. Evidence of therapeutic benefit of one treatment option over another is lacking. Prognosis remains dismal with a median survival of 2-12 months Surgery remains an important component of the multimodal therapy and is commonly adopted as primary treatment. Although radical resection should be discouraged, resection without inducing significant morbidity can be considered for good risk patients with resectable tumors. It provides an effective form of palliation with potential cure when combined with postoperative radiotherapy and/or chemotherapy. Patients selected for surgical resection was frequently identified to have improved survival. A regime of preoperative hyperfractionated radiotherapy and doxorubicin followed by surgery when feasible has been documented to achieve local control and avoid tracheostomy for ATC patients. Because of the ineffectiveness of all conventional treatment modalities, novel molecular targeted therapies are being developed to tackling this uniformly fatal disease with promising results.

show abstract

“…The frequency of its occurrence is low but it is highly malignant, and local expansion and distant metastasis progress rapidly; to date, no effective treatment has been established [ 1 , 2 ]. Multimodal therapy has been performed, but there are no known effective anticancer drugs [ 3 , 4 , 5 , 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Significant Amelioration of Tracheal Stenosis following Lenvatinib in a Patient Who Has Anaplastic Thyroid Carcinoma with Bronchomediastinal Infiltration: A Case Report

Fukuhara¹,

Donishi²,

Koyama³

et al. 2017

Case Rep Oncol

View full text Add to dashboard Cite

Background: Anaplastic thyroid carcinoma has an extremely poor prognosis, and no known drugs have exhibited acceptable efficacy. In recent years, novel anticancer tyrosine kinase inhibitors have been developed. We encountered a case of tracheal stenosis due to mediastinal and tracheal infiltration of anaplastic carcinoma for which lenvatinib exhibited remarkable effects; owing to this, airway management could be performed, even though the patient’s condition was considered critical. Case Report: A 55-year-old man presented with locally advanced anaplastic thyroid carcinoma that was observed to have mediastinal infiltration. Tracheal stenosis due to infiltration of the trachea occurred, and the condition of the patient rapidly deteriorated. Radiation and chemotherapy consisting of cetuximab, cisplatin, and fluorouracil were ineffective, but his tracheal stenosis was relieved 2 weeks after initiation of lenvatinib, after which the patient could be discharged. However, the lenvatinib was ineffective for his liver, bone, and brain metastatic lesions, and the patient remained in a critical condition. Conclusion: We encountered a case in which lenvatinib was effective for locally advanced anaplastic thyroid carcinoma, leading to an improvement in quality of life and a prolonged life. The drug was effective for the primary lesion, but mixed efficacy was noted for distant metastatic lesions.

show abstract

Thyroid cancer: Different outcomes to chemotherapy according to tumour histology

Cited by 13 publications

References 5 publications

Prognostic Factors and Survival Score for Patients With Anaplastic Thyroid Carcinoma: A Retrospective Study from a Regional Registry

Prognostic Factors and Survival Score for Patients With Anaplastic Thyroid Carcinoma: A Retrospective Study from a Regional Registry

Surgical Options in Undifferentiated Thyroid Carcinoma

Significant Amelioration of Tracheal Stenosis following Lenvatinib in a Patient Who Has Anaplastic Thyroid Carcinoma with Bronchomediastinal Infiltration: A Case Report

Contact Info

Product

Resources

About