Prognostic factors for Korean patients with anaplastic thyroid carcinoma

• Published in: Head & neck Vol. 29; no. 8; pp. 765 - 772
• Main Authors: Kim, Tae Yong, Kim, Kyung Won, Jung, Tae Sik, Kim, Jung Min, Kim, Sun Wook, Chung, Ki-Wook, Kim, Eun Young, Gong, Gyungyub, Oh, Young Lyun, Cho, Soo Youn, Yi, Ka Hee, Kim, Won Bae, Park, Do Joon, Chung, Jae Hoon, Cho, Bo Youn, Shong, Young Kee
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-08-2007; John Wiley & Sons
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Analysis of Variance; anaplastic carcinoma; Biological and medical sciences; Carcinoma - mortality; Carcinoma - pathology; Carcinoma - therapy; Combined Modality Therapy; Disease-Free Survival; Endocrinopathies; Female; Humans; impact of therapy; Korea - epidemiology; Lymphatic Metastasis; Male; Malignant tumors; Medical Records; Medical sciences; Middle Aged; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Otorhinolaryngology. Stomatology; Prognosis; prognostic factor; Retrospective Studies; Risk Factors; Survival Analysis; thyroid disease; Thyroid Neoplasms - mortality; Thyroid Neoplasms - pathology; Thyroid Neoplasms - therapy; Thyroid. Thyroid axis (diseases); Thyroidectomy; Asia; Korea; Endocrinopathy; Human; thyroid disease; Prognosis; prognostic factor; Stomatology; Thyroid diseases; Korean; ENT; Malignant tumor; Survival; Anaplastic thyroid carcinoma; Anaplastic carcinoma; Treatment; survival analysis; impact of therapy
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.20578

Background.
Anaplastic thyroid carcinoma (ATC), although rare, is one of the most aggressive human cancers, and patients with ATC have extremely poor prognoses despite various therapeutic measures. We wished to determine the prognostic factors of survival and effect of treatment on survival rate in patients with ATC.
Methods.
We retrospectively reviewed the medical records of the 121 patients (41 men and 80 women) diagnosed with ATC from January 1995 to June 2004 at 5 major referral centers in Korea.
Results.
Mean patient age at diagnosis was 64 ± 11 years (range, 17–84 years). Of the 121 patients, 11 (9%) had intrathyroidal tumors, 69 (57%) had extrathyroidal tumors or lymph node involvement, 29 (24%) had distant metastases, and 12 had no data about staging (9%). The mean tumor diameter was 5.5 ± 2.5 cm (range, 0.5–17.0 cm). At a median follow‐up of 41 months (range, 26–122 months), 8 patients were alive. Median survival time was 5.1 months. The disease‐specific survival rates were 42% at 6 months, 16% at 12 months, and 9% at 24 months. Sixteen patients (13%) received only supportive care, 25 (21%) received surgery alone, 20 (16%) received radiation treatment or chemotherapy without surgery, and 60 (50%) received surgery plus radiation treatment or chemotherapy. Multivariate analysis showed that age less than 60 years, tumor size less than 7 cm, and lesser extent of disease were independent predictors of lower disease‐specific mortality.
Conclusions.
Long‐term survival is possible for ATC patients less than 60 years old and with small localized tumors. Although aggressive multimodal therapy, including surgery, radiation treatment, and chemotherapy, was not significantly associated with improved survival, we advocate aggressive multimodal therapy in selected ATC patients with good prognostic factors. © 2007 Wiley Periodicals, Inc. Head Neck 2007