Combined surgical and radiation therapy
may be of benefit in patients with anaplastic carcinoma of the thyroid
(July 2005)
The background of the study. Patients with anaplastic
thyroid carcinomas have a very poor prognosis, and few survive for
more than a year after diagnosis. This study was done to describe
the manifestations and outcome in a large cohort of patients with
this tumor.
How the study was done. The study subjects were
all patients with anaplastic thyroid carcinoma seen at hospitals
in the states and metropolitan regions of the United States that
constitute the Surveillance, Epidemiology, and End Results (SEER)
program of the National Cancer Institute between 1973 and 2000.
The diagnosis was confirmed by pathological examination of the tumor.
The results of the study. During the 27-year period,
516 patients (345 women, 171 men; average age, 71 years) with anaplastic
carcinoma were reported to the program. The average tumor size was
6 cm (range, 1 to 15). The tumor was confined to the thyroid gland
in 7 percent, was locally invasive or involved cervical lymph nodes
in 38 percent, and had spread to distant sites in 43 percent; the
stage was not reported for 12 percent. Some thyroid surgery was
done in 49 percent, and 63 percent received radiation therapy.
The cancer-related death rate was 69 percent at 6 months and 81
percent at 12 months. The only statistically significant predictors
of a better prognosis were younger age, lesser extent of disease,
and combined surgical and external radiation therapy.
The conclusions of the study. Anaplastic thyroid
carcinoma is usually rapidly fatal; younger age, limited extent
of tumor, and combined surgical and external radiation therapy are
associated with a slightly better prognosis.
The original article. Kebebew E, Greenspan FS,
Clark OH, Woeber KA, McMillan A. Anaplastic thyroid carcinoma: treatment
outcome and prognostic factors. Cancer 2005;103:1330-5.
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