Anaplastic cancer of the thyroid: a summary
of 50 years' experience at a single institution
(March 2002)
The background of
the study. Approximately 2 percent of thyroid cancers are
anaplastic. They are by far the most aggressive type of thyroid
cancer, and most patients die within a year after diagnosis. This
study was done to define the clinical characteristics and effects
of treatment in all patients with anaplastic thyroid cancer seen
at a single institution over a prolonged period.
How the study was done. The records
of all patients with anaplastic thyroid cancer treated at the Mayo
Clinic between 1949 and 1999 were reviewed. The diagnosis was confirmed
in all patients by review of the original tissue sections.
The results of the study. There
were 134 patients with anaplastic thyroid cancer during the 50-year
interval, with no change in mean number per year during this period.
Eighty (60 percent) were women and 54 (40 percent) were men; the
mean age was 67 years. One hundred thirty patients (97 percent)
presented with a rapidly enlarging neck mass (mean size, 7 cm).
At diagnosis, most patients had positive lymph nodes in the neck,
and 62 patients (46 percent) had distant metastases.
Treatment consisted of palliation only or biopsy followed by external
radiation therapy or chemotherapy in 38 (28 percent). Ninety-six
patients (72 percent) underwent surgery; it was intended to be curative
in 35 patients (26 percent), was done to reduce the mass of tumor
in 48 patients (36 percent), and was limited to biopsy in the remainder.
Most patients received external radiation therapy after surgery,
but only 1 patient had any decrease in tumor size.
The median survival was three months; 13 patients (10 percent),
all treated surgically, survived for at least a year.
The conclusions of the study. Anaplastic
thyroid cancer is rapidly fatal, and few patients survive for more
than a year.
The original article. McIver B,
Hay ID, Giuffrida DF, Dvorak CE, Grant CS, Thompson GB, van Heerden
JA, Goellner JR. Anaplastic thyroid carcinoma: a 50-year experience
at a single institution. Surgery 2001;130:1028-34.
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