Prognostic Factors and Treatment Outcomes of 100 Cases of Anaplastic Thyroid Carcinoma

Akaishi, Junko; Sugino, Kiminori; Kitagawa, Wataru; Nagahama, Mitsuji; Kameyama, Kaori; Shimizu, Kazuo; Ito, Kunihiko; Ito, Koichi

doi:10.1089/thy.2010.0332

Cited by 131 publications

(127 citation statements)

References 46 publications

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“…The median OS reported in the current study was 3 months which is less than the 3.9 months median OS of 100 patients reported by Akaishi et al 12 , but similar to the 2.8 median OS of 13 patients studied by Lim et al 26 . Several studies have examined the factors affecting prognosis in patients with ATC.…”

Section: Discussionsupporting

confidence: 72%

“…Several studies have examined the factors affecting prognosis in patients with ATC. The prognostic factors include patient age, tumor size, and clinical stage which should be considered when evaluating patients for treatment 12 . Univariate and multivariate analyses of factors affecting survival by Kihara et al showed that complete surgery was an independent prognostic factor 43 .…”

Section: Discussionmentioning

confidence: 99%

“…Anaplastic thyroid cancer should be treated as a medical emergency due to its aggressive nature 12 . By definition ATC is a stage IV disease which is subdivided into A, B, C according to local and distant metastases 13 .…”

Section: Introductionmentioning

confidence: 99%

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Treatment Outcome and Prognostic Factors of Anaplastic Thyroid Carcinoma: A Single Institution Experience in Egypt

Ibrahim

Askoura

2018

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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Introduction: Anaplastic thyroid carcinoma (ATC) is a rare lethal malignancy. It is one of the most aggressive human malignancies with limited progress in finding effective therapies. Aim: We aimed to study the treatment outcome and prognostic factors of ATC patients treated at our institution. Methods: We retrospectively analyzed charts of 30 ATC patients, treated at the Clinical Oncology Department, AinShams University from 2006 to 2017. The clinical characteristics and factors affecting survival were studied. Kaplan-Meier survival curve was used to analyze the overall survival (OS) of the patients. Results: The median age of patients was 60 years and males represented 63% of them. Almost half of patients (47%) had stage IVA disease. Equal number of patients received combined modality treatment versus single modality treatment (37% each). The median OS was 3 months (95% Confidence interval: 1.429-4.571). Variables associated with significantly better OS in univariate analysis included male sex (p=0.04), stage IVA disease (p=0.012), surgical treatment (p=0.034), radiotherapy (p=0.003), and combined modality treatment (p=0.005). However, only female sex was identified as significant poor prognostic variable of OS (p=0.043) by multivariate analysis. Conclusion: Our results of treatment outcome and prognosis of ATC agree with most of the literature. Multimodality treatment is currently the standard of care. While still there is no successful treatment of this rapidly fatal disease, exploration of novel therapies and approaches are warranted to help improve the outcome.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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Treatment Outcome and Prognostic Factors of Anaplastic Thyroid Carcinoma: A Single Institution Experience in Egypt

Ibrahim

Askoura

2018

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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“…Multimodal therapies, including surgery, radiation and chemotherapy, are generally used to manage this highly malignant disease. However, the prognosis is poor and the majority of the patients succumb to the disease within a year, with a median survival time of <6 months from the initial diagnosis (1)(2)(3). Recently, new approaches to treating ATC by targeted molecular markers have been developed to overcome therapeutic resistance (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Significant cytostatic effect of everolimus on a gefitinib-resistant anaplastic thyroid cancer cell line harboring PI3KCA gene mutation

Onoda

Nakamura

Aomatsu

et al. 2015

Molecular and Clinical Oncology

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Abstract. We previously demonstrated the efficacy of gefitinib, a tyrosine kinase inhibitor of the epidermal growth factor receptor (EGFR), on an anaplastic thyroid cancer (ATC) cell line. We also observed that gefitinib was not effective in regulating cell growth in a different ATC cell line that exhibited an altered EGFR-initiated signal transduction pathway. In the present study, we attempted to regulate the downstream effector of EGFR-Akt-mammalian target of rapamycin (mTOR) pathway by an mTOR inhibitor, everolimus. A total of 8 ATC cell lines were employed, 7 of which were established in our institute. OCUT-2 was known to carry a mutation in the phosphoinositide-3-kinase, catalytic, α polypeptide gene (PI3KCA) and to be gefitinib-resistant, whereas ACT-1 exhibited a remarkable growth arrest by gefitinib. All the cell lines were tested for the cytotoxic effect of everolimus. The mechanisms of cellular toxicity were investigated by EGFR stimulation, cell cycle and concurrent exposure to paclitaxel. In OCUT-2, but not in any of the other cell lines, everolimus achieved a significant growth inhibition (inhibition of 30 and 50% was achieved by concentrations of 0.8 and 5 nM, respectively). The growth in OCUT-2 was inhibited by everolimus, even with concordant EGFR stimulation. This effect was demonstrated by a G2M cell cycle arrest. An additive effect of everolimus onto the cytotoxic effect of paclitaxel was demonstrated at a dose of 1-2 nM. A significant growth inhibitory effect of everolimus on the gefitinib-resistant ATC cell line was demonstrated, suggesting a possible correlation between the efficacy of everolimus and PI3KCA gene mutation and the significance of molecular-targeted therapy in the management of ATC.

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“…Multimodality treatment (combination of surgery, radiation and chemotherapy) is the most effective therapy that has been shown to improve outcome for stages IVA, and resectable stage IVB disease with a 1 year survival up to 70%, 2 year survival of 60%, and 50% living beyond 2.5 years with a median survival of 5 years [3,4]. Current treatment guidelines recommend surgical resection if possible for locoregional disease (stage IVA and resectable IVB) and stabilization of airway patency in all patients.…”

mentioning

confidence: 99%

Unravelling the best combination of therapies to treat anaplastic thyroid cancer

Abate

Smallridge

2016

Expert Review of Endocrinology & Metabolism

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Prognostic Factors and Treatment Outcomes of 100 Cases of Anaplastic Thyroid Carcinoma

Abstract: Although the prognosis of most patients with ATC continues to be poor, surgery, radiotherapy, and a combination of both improved the survival of patients with ATC.

Cited by 131 publications

References 46 publications

Treatment Outcome and Prognostic Factors of Anaplastic Thyroid Carcinoma: A Single Institution Experience in Egypt

Treatment Outcome and Prognostic Factors of Anaplastic Thyroid Carcinoma: A Single Institution Experience in Egypt

Significant cytostatic effect of everolimus on a gefitinib-resistant anaplastic thyroid cancer cell line harboring PI3KCA gene mutation

Unravelling the best combination of therapies to treat anaplastic thyroid cancer

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