The important role of operations in the management of anaplastic thyroid carcinoma

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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“…2,18,19) In this study, most of anaplastic foci group showed long term survival and 66.7% (12/18) patients were younger than 60 years old.…”

Section: Discussionsupporting

confidence: 48%

Clinical Characteristics and Prognosis of Differentiated Thyroid Carcinoma with Small Foci of Anaplastic Transformation

et al. 2017

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“…EBRT combined with surgery can improve local control, and chemotherapy combined with EBRT can increase the radiosensitivity of ATC. 45,47,81,83,100 Controversy persists over the timing of chemoradiation in relation to surgery. Several authors believe that administering EBRT postoperatively provides a theoretical advantage by allowing radiation to treat a smaller tumor burden.…”

Section: Surgerymentioning

confidence: 99%

Poorly Differentiated and Anaplastic Thyroid Cancer

2006

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Background: Poorly differentiated thyroid carcinoma (PDTC) and anaplastic (undifferentiated) thyroid carcinoma (ATC) comprise a small subset of thyroid tumors that are associated with a poor prognosis and account for Shaha, MD, FACS, Head and Neck Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021. E-mail: shahaa@mskcc.org No significant relationship exists between the authors and the companies/organizations whose products or services may be referenced in this article. Abbreviations used in this paper: PDTC = poorly differentiated thyroid carcinoma, WDTC = well-differentiated thyroid carcinoma, ATC = anaplastic thyroid carcinoma, ITC = insular thyroid carcinoma, FNAB = fine-needle aspiration biopsy, TG = thyroglobulin, RAI = radioactive iodine, EBRT = external-beam radiation therapy.

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“…This response is further enhanced when hyperfractionated radiotherapy is combined [13]. On the other hand, some authors mention that the indication of chemotherapy is limited by its toxicity, especially in elderly or multi-tared subjects [11,21,24]. In a study from Serbia, between 1997 and 2007, 16 inoperable patients were treated with radiotherapy at 60 Gy followed by doxorubicin 60 mg/m2 and cisplatin 40 mg/m2 every 3 weeks.…”

Section: Chemotherapymentioning

confidence: 99%

“…According to the study by Voutilainen [4], 33 patients with anaplastic thyroid carcinoma, 30% required an emergency tracheotomy. The cytological and even histological diagnosis of anaplastic carcinoma of the thyroid is not always easy, thus posing several differential diagnoses such as thyroiditis, insular carcinoma, medullary carcinoma, thyroid lymphomas and thyroid metastases of another carcinoma [11][12][13], hence the importance of the immunohistochemical study in the diagnosis of this tumor which makes it possible to detect the presence of FAS proteins and cytokeratin and the negativity of the other classical tumor markers of thyroid cancers (thyroglobulin, Calcitonin, ACE) [14]. In our patient immunohistochemical study after fixation and inclusion in paraffin shows: intensive and focal cytoplasmic expression of the tumor cells of the anticytokine antibody (clone AE1 / AE3, DAKO) with negativity of the other conventional tumor markers.…”

Section: Notementioning

confidence: 99%

Rapid Recurrence of Anaplastic Carcinoma: Advocacy towards Non-Surgery

Habra¹

2017

EMIJ

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DiscussionThe majority of anaplastic cancers are revealed by the rapid transformation of an old goitre: increase in volume, pain, dysphonia, dyspnea by tracheal compression and dysphagia thereafter. The nodal invasions, the repercussion on the general state, immediately sign the gravity of the situation. The cervical ultrasound is not specific but allows suspecting a malignant AbstractAnaplastic carcinoma of the thyroid (ATC) is a rare but aggressive tumor, its prognosis is dark. Most patients diagnosed with this disease are 65 years of age or older, treatment is based on the combined action of radiotherapy, chemotherapy and surgical removal when possible. We report a case of anaplastic carcinoma of the thyroid which has been thundering in postoperative surgery after total thyroidectomy, this case highlights the ineffectiveness of surgery in the reduction of tumor mass. Surely contribute to a historical recurrence and aggravate the prognosis. We will study through a review of the literature the clinical aspects and discuss the therapeutic modalities of this cancer.Keywords: Anaplastic thyroid carcinoma; Therapeutic modalities

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The important role of operations in the management of anaplastic thyroid carcinoma

Cited by 101 publications

References 17 publications

Clinical Characteristics and Prognosis of Differentiated Thyroid Carcinoma with Small Foci of Anaplastic Transformation

Clinical Characteristics and Prognosis of Differentiated Thyroid Carcinoma with Small Foci of Anaplastic Transformation

Poorly Differentiated and Anaplastic Thyroid Cancer

Rapid Recurrence of Anaplastic Carcinoma: Advocacy towards Non-Surgery

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