Impact of Timeliness of Resection and Thyroidectomy Margin Status on Survival for Patients with Anaplastic Thyroid Cancer: An Analysis of 335 Cases

Abstract

Timely and aggressive surgical management should be pursued in patients with intrathyroidal disease; however, aggressive resections may not be recommended for patients with stage IVB and IVC disease when morbidity and operative risks outweigh the limited benefits of surgery.

Anaplastic thyroid carcinoma: review of treatment protocols

“…The confounding effect might become apparent when we note that in this study, the extent of surgery (i.e. R0 vs R1 vs R2) did not affect the overall survival thus contradicting the general positive effect of surgery (Goffredo et al 2015).…”

Anaplastic thyroid carcinoma: review of treatment protocols

“…The confounding effect might become apparent when we note that in this study, the extent of surgery (i.e. R0 vs R1 vs R2) did not affect the overall survival thus contradicting the general positive effect of surgery (Goffredo et al 2015).…”

Exploration of systematic treatment strategies for anaplastic thyroid carcinoma: A single-institutional retrospective study

“…In the analytical result, the patients who underwent surgery obtained a better prognosis and there was a statistically signi cant difference (P<0.05). Paolo et al analyzed a cohort of 335 patients with ATC who underwent surgery and observed that aggressive resections were adapted for patients with stage IVA, but the patients with stage IVB or IVC should balance bene t and harm comprehensively before the operation [14]. In this study, survival was improved in IVA and IVB patients who underwent surgery, while no statistically signi cant was found in patients with IVC (P>0.05).…”

Evaluation of Treatment Response and Survival Outcomes in Anaplastic Thyroid Cancer Patients Following Surgery With and Without Other Treatment Modalities: A Systematic Review

“…Several investigations have demonstrated that curative surgery, as a positive prognostic factor in ATC management, was associated with prolonged OS [ 6 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. The patients who received surgery as the primary treatment experienced extended survival outcomes compared to other patients [ 6 , 24 , 25 , 34 ].…”

“…Regarding staging, eligible patients for aggressive surgical resections in all stages of ATC demonstrated prolonged OS than the patients who received not curative debulking or palliative surgery [ 7 , 22 , 23 , 26 , 27 , 29 , 49 , 50 , 51 ]. However, patients with distant metastasis and advanced stages of ATC showed higher recurrence rates and significantly lower OS after surgery in comparison with the subjects without distant metastasis and lower stages of ATC [ 14 , 17 , 34 ].…”

“…However, patients with distant metastasis and advanced stages of ATC showed higher recurrence rates and significantly lower OS after surgery in comparison with the subjects without distant metastasis and lower stages of ATC [ 14 , 17 , 34 ]. In detail, a higher number of patients with localized ATC, such as the IVA stage, received curative surgical resection of the tumor and depicted a significantly longer mean survival time compared to the patients with advanced ATC [ 17 , 26 , 50 , 52 , 53 ]. Nonetheless, in some studies, negative margin status did not have a significant effect on the survival outcomes of patients with IVC stage [ 26 ].…”

Anaplastic thyroid carcinoma: review of treatment protocols

“…The confounding effect might become apparent when we note that in this study, the extent of surgery (i.e. R0 vs R1 vs R2) did not affect the overall survival thus contradicting the general positive effect of surgery (Goffredo et al 2015).…”

Exploration of systematic treatment strategies for anaplastic thyroid carcinoma: A single-institutional retrospective study

“…In the analytical result, the patients who underwent surgery obtained a better prognosis and there was a statistically signi cant difference (P<0.05). Paolo et al analyzed a cohort of 335 patients with ATC who underwent surgery and observed that aggressive resections were adapted for patients with stage IVA, but the patients with stage IVB or IVC should balance bene t and harm comprehensively before the operation [14]. In this study, survival was improved in IVA and IVB patients who underwent surgery, while no statistically signi cant was found in patients with IVC (P>0.05).…”

Evaluation of Treatment Response and Survival Outcomes in Anaplastic Thyroid Cancer Patients Following Surgery With and Without Other Treatment Modalities: A Systematic Review

“…Several investigations have demonstrated that curative surgery, as a positive prognostic factor in ATC management, was associated with prolonged OS [ 6 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. The patients who received surgery as the primary treatment experienced extended survival outcomes compared to other patients [ 6 , 24 , 25 , 34 ].…”

“…Regarding staging, eligible patients for aggressive surgical resections in all stages of ATC demonstrated prolonged OS than the patients who received not curative debulking or palliative surgery [ 7 , 22 , 23 , 26 , 27 , 29 , 49 , 50 , 51 ]. However, patients with distant metastasis and advanced stages of ATC showed higher recurrence rates and significantly lower OS after surgery in comparison with the subjects without distant metastasis and lower stages of ATC [ 14 , 17 , 34 ].…”

“…However, patients with distant metastasis and advanced stages of ATC showed higher recurrence rates and significantly lower OS after surgery in comparison with the subjects without distant metastasis and lower stages of ATC [ 14 , 17 , 34 ]. In detail, a higher number of patients with localized ATC, such as the IVA stage, received curative surgical resection of the tumor and depicted a significantly longer mean survival time compared to the patients with advanced ATC [ 17 , 26 , 50 , 52 , 53 ]. Nonetheless, in some studies, negative margin status did not have a significant effect on the survival outcomes of patients with IVC stage [ 26 ].…”

Anaplastic thyroid carcinoma: review of treatment protocols

“…The confounding effect might become apparent when we note that in this study, the extent of surgery (i.e. R0 vs R1 vs R2) did not affect the overall survival thus contradicting the general positive effect of surgery (Goffredo et al 2015).…”

Exploration of systematic treatment strategies for anaplastic thyroid carcinoma: A single-institutional retrospective study

“…In the analytical result, the patients who underwent surgery obtained a better prognosis and there was a statistically signi cant difference (P<0.05). Paolo et al analyzed a cohort of 335 patients with ATC who underwent surgery and observed that aggressive resections were adapted for patients with stage IVA, but the patients with stage IVB or IVC should balance bene t and harm comprehensively before the operation [14]. In this study, survival was improved in IVA and IVB patients who underwent surgery, while no statistically signi cant was found in patients with IVC (P>0.05).…”

Evaluation of Treatment Response and Survival Outcomes in Anaplastic Thyroid Cancer Patients Following Surgery With and Without Other Treatment Modalities: A Systematic Review

“…Several investigations have demonstrated that curative surgery, as a positive prognostic factor in ATC management, was associated with prolonged OS [ 6 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. The patients who received surgery as the primary treatment experienced extended survival outcomes compared to other patients [ 6 , 24 , 25 , 34 ].…”

“…Regarding staging, eligible patients for aggressive surgical resections in all stages of ATC demonstrated prolonged OS than the patients who received not curative debulking or palliative surgery [ 7 , 22 , 23 , 26 , 27 , 29 , 49 , 50 , 51 ]. However, patients with distant metastasis and advanced stages of ATC showed higher recurrence rates and significantly lower OS after surgery in comparison with the subjects without distant metastasis and lower stages of ATC [ 14 , 17 , 34 ].…”

“…However, patients with distant metastasis and advanced stages of ATC showed higher recurrence rates and significantly lower OS after surgery in comparison with the subjects without distant metastasis and lower stages of ATC [ 14 , 17 , 34 ]. In detail, a higher number of patients with localized ATC, such as the IVA stage, received curative surgical resection of the tumor and depicted a significantly longer mean survival time compared to the patients with advanced ATC [ 17 , 26 , 50 , 52 , 53 ]. Nonetheless, in some studies, negative margin status did not have a significant effect on the survival outcomes of patients with IVC stage [ 26 ].…”