Anaplastic thyroid carcinoma: A 50-year experience at a single institution

McIver, Bryan; Hay, Ian; Giuffrida, Dario; Dvorak, Catherine E.; Grant, Clive S.; Thompson, Geoffrey B.; Heerden, Jon A. van; Goellner, John R.

doi:10.1067/msy.2001.118266

Cited by 431 publications

(360 citation statements)

References 18 publications

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“…Nevertheless, it is one of the most lethal human malignant tumors, accounting for about one-half of all thyroid carcinoma deaths (2-4). ATC usually presents as a rapidly enlarging neck mass, often associated with vocal cord paralysis, dyspnea and/or dysphagia, with an F:M ratio of 1.5:1 and a peak of incidence in the sixth and seventh decades of life (5,6). In stark contrast to the behavior of well-differentiated (papillary or follicular) thyroid cancer, ATC typically follows a rapid and lethal clinical course, with median survival below 6 months in the majority of series reported.…”

Section: Introductionmentioning

confidence: 99%

Anaplastic thyroid carcinoma: clinical outcome of 30 consecutive patients referred to a single institution in the past 5 years

et al. 2007

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Objective: Treatment options for anaplastic thyroid carcinoma (ATC), which is one of the most lethal human malignant tumors, include surgery, chemotherapy and radiotherapy usually combined in a multimodal approach, to improve survival and avoid death from local invasion. However, there is no standard protocol for ATC treatment and the optimal sequence within multimodal therapy is debated. We retrospectively report the clinical outcome of 30 ATC patients referred consecutively to the Oncological Endocrinology Unit of San Giovanni Battista Hospital (Turin, Italy) between 2000 and 2005. Design: Patients were treated by one of the following approaches: i) surgery followed by adjuvantcombined chemoradiotherapy; ii) neo-adjuvant chemoradiotherapy followed by surgery and adjuvant chemotherapy; or iii) chemotherapy alone. The surgical procedures were classified as 'maximal debulking' or 'palliative resection'. Maximal debulking entailed total or near-total thyroidectomy and complete resection of all gross tumor or minimal residual disease adherent to vital structures, independently of the presence or absence of distant metastases. In palliative resections, macroscopic residual disease was left in the neck. Survival of patients stratified by treatment was assessed. Results: Analysis of multivariate hazard ratios showed that maximal debulking followed by adjuvant chemoradiotherapy was the only treatment that modified survival of ATC patients (hazard ratioZ 0.23, 95% CI: 0.07-0.79), even if factors determining poor prognosis or increased surgical risk were present. Conclusions: Despite the overall grim outcome of ATC, these results justify an attempt at maximal debulking surgery, followed by adjuvant chemoradiotherapy, possibly in all ATC patients. 156 425-430 European Journal of Endocrinology

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Section: Introductionmentioning

confidence: 99%

Anaplastic thyroid carcinoma: clinical outcome of 30 consecutive patients referred to a single institution in the past 5 years

et al. 2007

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“…One is that ATC concurrent with DTC was found about 50% (23-71%) in several cohort studies about ATC patients. 5,7,8,13) In a study analyzing entire tumor sections, every ATC contained components of papillary or follicular carcinoma or both. 14) Second evidence is that BRAF mutation was found in ATC with PTC component.…”

Section: Discussionmentioning

confidence: 99%

“…5,6) ATC is commonly related with previous or concurrent thyroid disorders, including DTC. 7,8) This pathological association of ATC with DTC has led to the emergence of the concept of anaplastic transformation which means an intratumoral evolution or progression from DTC to ATC. 9) According to the Surveillance, Epidemiology and End Results (SEER) Program of National Cancer Institute, incidence of ATC has decreased by 22% during 1973-2003.…”

Section: Introductionmentioning

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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“…Age, sex, size of the tumor, resectability, and the extent of disease has been shown to affect the course of the disease (Chen et al, 2008). In a SEER-based study in the United States by multivariate analysis, only age less than 60 years, an intra-thyroidal tumor, and the combined use of surgical and external beam radiation therapy were identified as independent predictors of lower cause-specific mortality (McIver et al, 2001). In other series, female sex, tumor size less than 6 cm, age, and the extent of disease were the most favorable prognostic markers (Tan et al, 1995;Dziba et al, 2002).…”

Section: Prognosismentioning

confidence: 99%

“…In contrast to other anti-angiogenetic drugs that block the formation of new vessels in tumors, vascular disrupting agents (such as CA4P) stop blood flow through already existing vessels, with the result of depriving tumor cells of oxygen and nutrients (McIver et al, 2001;Tozer et al, 2002). CA4P has activity against ATC cell lines and xenograft (Dowlati et al, 2002).…”

Section: Anti-angiogenetic Agentsmentioning

confidence: 99%