J Korean Surg Soc.  2012 Sep;83(3):123-129. 10.4174/jkss.2012.83.3.123.

Analysis of patients with anaplastic thyroid cancer expected to have curative surgery

• Oh EM
• Lee KE
• Kwon H
• Kim EY
• Bae DS
• Youn YK

• KMID: 2212283
• DOI: http://doi.org/10.4174/jkss.2012.83.3.123

Abstract

PURPOSE
Anaplastic thyroid cancer (ATC) is rare and has a poor prognosis. The aim of this study was to analyze the clinicopathologic characteristics of patients diagnosed with ATC expected to undergo curative thyroidectomy, with the goal of finding differences between patients surviving > or =6 months and <6 months.
METHODS
From 1981 to 2010, 24 patients underwent thyroidectomy due to ATC. Among those patients, 12 suspected of distant metastasis preoperatively were excluded. The remaining 12 patients were analyzed by retrospective review of electronic medical records.
RESULTS
Median age was 55 years, and the male to female ratio was 1:5. All patients presented with neck mass at initial diagnosis. Five patients lived <6 months and seven patients lived > or =6 months after operation. In patients surviving > or =6 months, all lesions were <5 cm and all patients underwent total thyroidectomy. In patients surviving <6 months, two of the four lesions were >5 cm, and two of the five patients underwent less than total thyroidectomy (P = 0.287 and 0.152, respectively). All patients with lesion size <5 cm underwent total thyroidectomy and showed a shorter median operation time (P = 0.182 and 0.033, respectively).
CONCLUSION
ATC showed female predominance. Patients initially presented with neck mass, and median age was 55 years. In patients with ATC who are expected to undergo curative thyroidectomy, surgery should actively be considered as primary therapy for patient survival when the size is <5 cm.

Keyword

Anaplastic thyroid cancer; Thyroidectomy

MeSH Terms

Electronics
Electrons
Female
Humans
Male
Neck
Neoplasm Metastasis
Prognosis
Retrospective Studies
Thyroid Gland
Thyroid Neoplasms
Thyroidectomy
Thyroid Neoplasms

Reference

1. Venkatesh YS, Ordonez NG, Schultz PN, Hickey RC, Goepfert H, Samaan NA. Anaplastic carcinoma of the thyroid: a clinicopathologic study of 121 cases. Cancer. 1990. 66:321–330.

2. Heron DE, Karimpour S, Grigsby PW. Anaplastic thyroid carcinoma: comparison of conventional radiotherapy and hyperfractionation chemoradiotherapy in two groups. Am J Clin Oncol. 2002. 25:442–446.

3. Pierie JP, Muzikansky A, Gaz RD, Faquin WC, Ott MJ. The effect of surgery and radiotherapy on outcome of anaplastic thyroid carcinoma. Ann Surg Oncol. 2002. 9:57–64.

4. Tennvall J, Lundell G, Wahlberg P, Bergenfelz A, Grimelius L, Akerman M, et al. Anaplastic thyroid carcinoma: three protocols combining doxorubicin, hyperfractionated radiotherapy and surgery. Br J Cancer. 2002. 86:1848–1853.

5. Kihara M, Miyauchi A, Yamauchi A, Yokomise H. Prognostic factors of anaplastic thyroid carcinoma. Surg Today. 2004. 34:394–398.

6. Chang HS, Nam KH, Chung WY, Park CS. Anaplastic thyroid carcinoma: a therapeutic dilemma. Yonsei Med J. 2005. 46:759–764.

7. Kebebew E, Greenspan FS, Clark OH, Woeber KA, McMillan A. Anaplastic thyroid carcinoma: treatment outcome and prognostic factors. Cancer. 2005. 103:1330–1335.

8. Hundahl SA, Fleming ID, Fremgen AM, Menck HR. A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985-1995. Cancer. 1998. 83:2638–2648.

9. Goutsouliak V, Hay JH. Anaplastic thyroid cancer in British Columbia 1985-1999: a population-based study. Clin Oncol (R Coll Radiol). 2005. 17:75–78.

10. Are C, Shaha AR. Anaplastic thyroid carcinoma: biology, pathogenesis, prognostic factors, and treatment approaches. Ann Surg Oncol. 2006. 13:453–464.

11. Hadar T, Mor C, Shvero J, Levy R, Segal K. Anaplastic carcinoma of the thyroid. Eur J Surg Oncol. 1993. 19:511–516.

12. Agrawal S, Rao RS, Parikh DM, Parikh HK, Borges AM, Sampat MB. Histologic trends in thyroid cancer 1969-1993: a clinico-pathologic analysis of the relative proportion of anaplastic carcinoma of the thyroid. J Surg Oncol. 1996. 63:251–255.

13. Kim TY, Kim KW, Jung TS, Kim JM, Kim SW, Chung KW, et al. Prognostic factors for Korean patients with anaplastic thyroid carcinoma. Head Neck. 2007. 29:765–772.

14. Higashiyama T, Ito Y, Hirokawa M, Masuoka H, Yabuta T, Fukushima M, et al. Optimal surgical procedure for locally curative surgery in patients with anaplastic thyroid carcinoma: importance of preoperative ultrasonography. Endocr J. 2010. 57:763–769.

15. McIver B, Hay ID, Giuffrida DF, Dvorak CE, Grant CS, Thompson GB, et al. Anaplastic thyroid carcinoma: a 50-year experience at a single institution. Surgery. 2001. 130:1028–1034.

16. Siironen P, Hagstrom J, Maenpaa HO, Louhimo J, Heikkila A, Heiskanen I, et al. Anaplastic and poorly differentiated thyroid carcinoma: therapeutic strategies and treatment outcome of 52 consecutive patients. Oncology. 2010. 79:400–408.

17. Perri F, Lorenzo GD, Scarpati GD, Buonerba C. Anaplastic thyroid carcinoma: a comprehensive review of current and future therapeutic options. World J Clin Oncol. 2011. 2:150–157.

18. Brignardello E, Gallo M, Baldi I, Palestini N, Piovesan A, Grossi E, et al. Anaplastic thyroid carcinoma: clinical outcome of 30 consecutive patients referred to a single institution in the past 5 years. Eur J Endocrinol. 2007. 156:425–430.

19. Haigh PI, Ituarte PH, Wu HS, Treseler PA, Posner MD, Quivey JM, et al. Completely resected anaplastic thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival. Cancer. 2001. 91:2335–2342.

20. Wein RO, Weber RS. Anaplastic thyroid carcinoma: palliation or treatment? Curr Opin Otolaryngol Head Neck Surg. 2011. 19:113–118.

21. Green LD, Mack L, Pasieka JL. Anaplastic thyroid cancer and primary thyroid lymphoma: a review of these rare thyroid malignancies. J Surg Oncol. 2006. 94:725–736.

22. Kim HY, Chung KW, Kim HW, Youn YK, Oh SK. Clinical analysis of anaplastic thyroid carcinoma. J Korean Surg Soc. 2001. 61:142–147.

23. Sipos JA, Mazzaferri EL. Thyroid cancer epidemiology and prognostic variables. Clin Oncol (R Coll Radiol). 2010. 22:395–404.

24. Demeter JG, De Jong SA, Lawrence AM, Paloyan E. Anaplastic thyroid carcinoma: risk factors and outcome. Surgery. 1991. 110:956–961.

25. Bakiri F, Djemli FK, Mokrane LA, Djidel FK. The relative roles of endemic goiter and socioeconomic development status in the prognosis of thyroid carcinoma. Cancer. 1998. 82:1146–1153.