Skip to main content
SpringerLink
Log in

Anaplastic Thyroid Carcinoma: A 25-year Single-Institution Experience

  • Endocrine Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Anaplastic thyroid carcinoma (ATC) is among the most aggressive solid tumors accounting for 1–5 % of primary thyroid malignancies. In this retrospective review, we aim to evaluate the prognostic factors, treatment approaches, and outcomes of patients with ATC treated at a single institution.

Materials and Methods

We retrospectively identified 95 patients with ATC from an institutional database between 1985 and 2010. A total of 83 patients with sufficient records were included in this study. Patient, tumor, and treatment characteristics were recorded. Disease-specific survival (DSS) was determined by the Kaplan–Meier method, and factors predictive of outcome were determined by univariate and multivariate analysis.

Results

Of the 83 patients, 41 were male and 42 were female. The median age at presentation was 60 years (range 28–89 years) with a median survival of 8 months. The 1- and 2-year DSS were 33 and 23 %, respectively. On univariate analysis, age less than 60 years, clinically N0 neck, absence of clinical extrathyroidal extension (cETE), gross total resection, and multimodality treatment were statistically significant predictors of improved survival. On multivariate analysis, absence of cETE, multimodality therapy, and gross total resection were predictors of improved outcome.

Conclusions

In patients with locoregional limited disease, multimodality treatment with gross total surgical resection and postoperative radiotherapy with or without chemotherapy offers the best local control and DSS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ain KB. Anaplastic thyroid carcinoma: a therapeutic challenge. Semin Surg Oncol. 1999;16:64–9.

    Article  CAS  PubMed  Google Scholar 

  2. Rafla S. Anaplastic tumors of the thyroid. Cancer. 1969;23:668–77.

    Article  CAS  PubMed  Google Scholar 

  3. Hundahl SA, Fleming ID, Fremgen AM, Menck HR. A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985–1995 [see comments]. Cancer. 1998;83:2638–48.

    Article  CAS  PubMed  Google Scholar 

  4. Smallridge RC, Copland JA. Anaplastic thyroid carcinoma: pathogenesis and emerging therapies. Clin Oncol (R Coll Radiol). 2010;22:486–97.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Ain KB. Anaplastic thyroid carcinoma: behavior, biology, and therapeutic approaches. Thyroid. 1998;8:715–26.

    Article  CAS  PubMed  Google Scholar 

  6. Are C, Shaha AR. Anaplastic thyroid carcinoma: biology, pathogenesis, prognostic factors, and treatment approaches. Ann Surg Oncol. 2006;13:453–64.

    Article  PubMed  Google Scholar 

  7. Kebebew E, Greenspan FS, Clark OH, Woeber KA, McMillan A. Anaplastic thyroid carcinoma. Treatment outcome and prognostic factors. Cancer. 2005;103:1330–5.

    Article  PubMed  Google Scholar 

  8. Hundahl SA, Cady B, Cunningham MP, Mazzaferri E, McKee RF, Rosai J, et al. Initial results from a prospective cohort study of 5583 cases of thyroid carcinoma treated in the united states during 1996. U.S. and German Thyroid Cancer Study Group. An American College of Surgeons Commission on Cancer Patient Care Evaluation study. Cancer. 2000;89:202–17.

    Article  CAS  PubMed  Google Scholar 

  9. Bakiri F, Djemli FK, Mokrane LA, Djidel FK. The relative roles of endemic goiter and socioeconomic development status in the prognosis of thyroid carcinoma. Cancer. 1998;82:1146–53.

    Article  CAS  PubMed  Google Scholar 

  10. Haigh PI, Ituarte PH, Wu HS, Treseler PA, Posner MD, Quivey JM, et al. Completely resected anaplastic thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival. Cancer. 2001;91:2335–42.

    Article  CAS  PubMed  Google Scholar 

  11. McIver B, Hay ID, Giuffrida DF, Dvorak CE, Grant CS, Thompson GB, et al. Anaplastic thyroid carcinoma: a 50-year experience at a single institution. Surgery. 2001;130:1028–34.

    Article  CAS  PubMed  Google Scholar 

  12. Venkatesh YS, Ordonez NG, Schultz PN, Hickey RC, Goepfert H, Samaan NA. Anaplastic carcinoma of the thyroid. A clinicopathologic study of 121 cases. Cancer. 1990;66:321–30.

    Article  CAS  PubMed  Google Scholar 

  13. Neff RL, Farrar WB, Kloos RT, Burman KD. Anaplastic thyroid cancer. Endocrinol Metab Clin North Am. 2008;37:525–38, xi.

    Article  PubMed  Google Scholar 

  14. Akaishi J, Sugino K, Kitagawa W, Nagahama M, Kameyama K, Shimizu K, et al. Prognostic factors and treatment outcomes of 100 cases of anaplastic thyroid carcinoma. Thyroid. 2011;21:1183–9.

    Article  PubMed  Google Scholar 

  15. Sugitani I, Miyauchi A, Sugino K, Okamoto T, Yoshida A, Suzuki S. Prognostic factors and treatment outcomes for anaplastic thyroid carcinoma: ATC Research Consortium of Japan cohort study of 677 patients. World J Surg. 2012;36:1247–54.

    Article  PubMed  Google Scholar 

  16. Sugitani I, Kasai N, Fujimoto Y, Yanagisawa A. Prognostic factors and therapeutic strategy for anaplastic carcinoma of the thyroid. World J Surg. 2001;25:617–22.

    Article  CAS  PubMed  Google Scholar 

  17. Swaak-Kragten AT, de Wilt JH, Schmitz PI, Bontenbal M, Levendag PC, Multimodality treatment for anaplastic thyroid carcinoma–treatment outcome in 75 patients. Radiother Oncol. 2009;92:100–4.

    Article  PubMed  Google Scholar 

  18. Passler C, Scheuba C, Prager G, Kaserer K, Flores JA, Vierhapper H, et al. Anaplastic (undifferentiated) thyroid carcinoma (ATC). A retrospective analysis. Langenbecks Arch Surg. 1999;384:284–93.

    Article  CAS  PubMed  Google Scholar 

  19. Kihara M, Miyauchi A, Yamauchi A, Yokomise H. Prognostic factors of anaplastic thyroid carcinoma. Surg Today. 2004;34:394–8.

    Article  PubMed  Google Scholar 

  20. Ito Y, Higashiyama T, Hirokawa M, Fukushima M, Inoue H, Yabuta T, et al. Investigation of the validity of UICC stage grouping of anaplastic carcinoma of the thyroid. Asian J Surg. 2009;32:47–50.

    Article  PubMed  Google Scholar 

  21. Pierie JP, Muzikansky A, Gaz RD, Faquin WC, Ott MJ. The effect of surgery and radiotherapy on outcome of anaplastic thyroid carcinoma. Ann Surg Oncol. 2002;9:57–64.

    Article  PubMed  Google Scholar 

  22. Tennvall J, Lundell G, Wahlberg P, Bergenfelz A, Grimelius L, Akerman M, et al. Anaplastic thyroid carcinoma: three protocols combining doxorubicin, hyperfractionated radiotherapy and surgery. Br J Cancer. 2002;86:1848–53.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. De Crevoisier R, Baudin E, Bachelot A, Leboulleux S, Travagli JP, Caillou B, et al. Combined treatment of anaplastic thyroid carcinoma with surgery, chemotherapy, and hyperfractionated accelerated external radiotherapy. Int J Radiat Oncol Biol Phys. 2004;60:1137–43.

    Article  PubMed  Google Scholar 

  24. Dandekar P, Harmer C, Barbachano Y, Rhys-Evans P, Harrington K, Nutting C, et al. Hyperfractionated Accelerated Radiotherapy (HART) for anaplastic thyroid carcinoma: toxicity and survival analysis. Int J Radiat Oncol Biol Phys. 2009;74:518–21.

    Article  PubMed  Google Scholar 

  25. Wong CS, Van Dyk J, Simpson WJ. Myelopathy following hyperfractionated accelerated radiotherapy for anaplastic thyroid carcinoma. Radiother Oncol. 1991;20:3–9.

    Article  CAS  PubMed  Google Scholar 

  26. Bhatia A, Rao A, Ang KK, Garden AS, Morrison WH, Rosenthal DI, et al. Anaplastic thyroid cancer: clinical outcomes with conformal radiotherapy. Head Neck. 2010;32:829–36.

    PubMed  Google Scholar 

  27. Jeong H, Kim YR, Kim KN, Choe JG, Chung JK, Kim MK. Effect of all-trans retinoic acid on sodium/iodide symporter expression, radioiodine uptake and gene expression profiles in a human anaplastic thyroid carcinoma cell line. Nucl Med Biol. 2006;33:875–82.

    Article  CAS  PubMed  Google Scholar 

  28. Tennvall J, Lundell G, Hallquist A, Wahlberg P, Wallin G, Tibblin S. Combined doxorubicin, hyperfractionated radiotherapy, and surgery in anaplastic thyroid carcinoma. Report on two protocols. The Swedish Anaplastic Thyroid Cancer Group. Cancer. 1994;74:1348–54.

    Article  CAS  PubMed  Google Scholar 

  29. Junor EJ, Paul J, Reed JS. Anaplastic thyroid carcinoma: 91 patients treated by surgery and radiotherapy. Eur J Surg Oncol. 1992;18:83–8.

    CAS  PubMed  Google Scholar 

  30. Kobayashi T, Asakawa H, Umeshita K, Takeda T, Maruyama H, Matsuzuka F, et al. Treatment of 37 patients with anaplastic carcinoma of the thyroid. Head Neck. 1996;18:36–41.

    Article  CAS  PubMed  Google Scholar 

  31. Nilsson O, Lindeberg J, Zedenius J, Ekman E, Tennvall J, Blomgren H, et al. Anaplastic giant cell carcinoma of the thyroid gland: treatment and survival over a 25-year period. World J Surg. 1998;22:725–30.

    Article  CAS  PubMed  Google Scholar 

  32. Lim SM, Shin SJ, Chung WY, Park CS, Nam KH, Kang SW, et al. Treatment outcome of patients with anaplastic thyroid cancer: a single center experience. Yonsei Med J. 2012;53:352–7.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Ito K, Hanamura T, Murayama K, Okada T, Watanabe T, Harada M, et al. Multimodality therapeutic outcomes in anaplastic thyroid carcinoma: improved survival in subgroups of patients with localized primary tumors. Head Neck. 2012;34:230–7.

    Article  PubMed  Google Scholar 

  34. Jereb B, Stjernsward J, Lowhagen T. Anaplastic giant-cell carcinoma of the thyroid. A study of treatment and prognosis. Cancer. 1975;35:1293–5.

    Article  CAS  PubMed  Google Scholar 

  35. Segerhammar I, Larsson C, Nilsson IL, Bäckdahl M, Höög A, Wallin G, et al. Anaplastic carcinoma of the thyroid gland: treatment and outcome over 13 years at one institution. J Surg Oncol. 2012;106:981–6.

    Article  PubMed  Google Scholar 

  36. O’Neill JP, Power D, Condron C, Bouchier-Hayes D, Walsh M. Anaplastic thyroid cancer, tumorigenesis and therapy. Ir J Med Sci. 2010;179:9–15.

    Article  PubMed  Google Scholar 

  37. Smallridge RC, Marlow LA, Copland JA. Anaplastic thyroid cancer: molecular pathogenesis and emerging therapies. Endocr Relat Cancer. 2009;16:17–44.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  38. Kojic SL, Strugnell SS, Wiseman SM. Anaplastic thyroid cancer: a comprehensive review of novel therapy. Expert Rev Anticancer Ther. 2011;11:387–402.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    A. Mohebati MD, M. DiLorenzo BA, F. Palmer BA, S. G. Patel MD, A. R. Shaha MD, J. P. Shah MD & I. Ganly MD, PhD

  2. Department of Medical Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    D. Pfister MD

  3. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    N. Lee MD

  4. Department of Endocrinology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    R. M. Tuttle MD

Authors
  1. A. Mohebati MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. DiLorenzo BA
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Palmer BA
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. G. Patel MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D. Pfister MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. N. Lee MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. R. M. Tuttle MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A. R. Shaha MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. J. P. Shah MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. I. Ganly MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to I. Ganly MD, PhD.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 17 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mohebati, A., DiLorenzo, M., Palmer, F. et al. Anaplastic Thyroid Carcinoma: A 25-year Single-Institution Experience. Ann Surg Oncol 21, 1665–1670 (2014). https://doi.org/10.1245/s10434-014-3545-5

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-014-3545-5

Keywords

Search

Navigation