Original communications| Volume 131, ISSUE 3, P245-248, March 2002

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


      Background. Anaplastic thyroid carcinoma is a rare and highly lethal neoplasm. We investigated whether operations have an impact on the survival of patients who have anaplastic carcinoma without distant metastasis. Methods. Between 1989 and 1999, 40 consecutive patients with anaplastic carcinoma, without distant metastasis at the time of presentation or during local treatment, were reviewed. The cumulative survival rates and 1-year survival rates were compared. Results. Eleven patients had a small focus of anaplastic carcinoma in a differentiated carcinoma, and 29 patients had ordinary anaplastic thyroid carcinoma. Surgical debulking was performed in 26 patients. Radiotherapy was used for 31 patients and chemotherapy for 19 patients. The 1-year survival rates of the patients with incidental anaplastic carcinoma, ordinary anaplastic carcinoma who underwent operations, and ordinary anaplastic carcinoma who did not undergo operations were 73%, 60%, and 21%, respectively. A significantly higher cumulative survival rate was observed in patients with incidental anaplastic carcinoma than in those with ordinary anaplastic carcinoma. A significantly better outcome was obtained by surgical debulking of ordinary anaplastic carcinoma. Conclusions. Patients with incidental anaplastic carcinoma tended to have a good outcome, but some had a poor prognosis. Surgical debulking improved the outcome of patients with ordinary anaplastic carcinoma. (Surgery 2002;131:245-8.)
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        • Aldinger KA
        • Samaan NA
        • Ibanez M
        • Hill Jr, CS
        Anaplastic carcinoma of the thyroid. A review of 84 cases of spindle and giant cell carcinoma of the thyroid.
        Cancer. 1978; 41: 2267-2275
        • Carcangiu ML
        • Steeper T
        • Zampi G
        • Rosai J.
        Anaplastic thyroid carcinoma. A study of 70 cases.
        Am J Clin Pathol. 1985; 83: 135-158
        • Kim JH
        • Leeper RD
        Treatment of anaplastic giant and spindle cell carcinoma of the thyroid gland with combination adriamycin and radiation therapy. A new approach.
        Cancer. 1983; 52: 954-957
        • Nel CJC
        • van Heerden JA
        • Goellner JR
        • et al.
        Anaplastic carcinoma of the thyroid: a clinicopathologic study of 82 cases.
        Mayo Clin Proc. 1985; 60: 51-58
        • Tallroth E
        • Wallin G
        • Lundell G
        • Lowhagen T
        • Einhorn J.
        Multimodality treatment in anaplastic giant cell thyroid carcinoma.
        Cancer. 1987; 60: 1428-1431
        • Spires JR
        • Schwartz MR
        • Miller RH
        Anaplastic thyroid carcinoma. Association with differentiated thyroid cancer.
        Arch Otolaryngol Head Neck Surg. 1988; 114: 40-44
        • Venkatesh YSS
        • Ordonez NG
        • Schultz PN
        • et al.
        Anaplastic carcinoma of the thyroid. A clinicopathological study of 121 cases.
        Cancer. 1990; 66: 321-330
        • Demeter JG
        • De Jong SA
        • Lawrence AM
        • Paloyan E.
        Anaplastic thyroid carcinoma: risk factors and outcome.
        Surgery. 1991; 110: 956-963
        • Tennvall J
        • Lundell G
        • Hallquist A
        • et al.
        Combined doxorubicin, hyperfractionated radiotherapy, and surgery in anaplastic thyroid carcinoma. Report on two protocols. The Swedish Anaplastic Thyroid Cancer Group.
        Cancer. 1994; 74: 1348-1354
        • Kobayashi T
        • Asakawa H
        • Umeshita K
        • et al.
        Treatment of 37 patients with anaplastic carcinoma of the thyroid.
        Head Neck. 1996; 18: 36-41
        • Lo C
        • Lam K
        • Wan K.
        Anaplastic carcinoma of the thyroid.
        Am J Surg. 1999; 177: 337-339
        • Voutilainen PE
        • Multanen M
        • Haapiainen RK
        • Leppaniemi AK
        • Sivula AH
        Anaplastic thyroid carcinoma survival.
        World J Surg. 1999; 23: 975-979
        • Lam L
        • Lo C
        • Chan K
        • Wan K.
        Insular and anaplastic carcinoma of the thyroid. A 45-year comparative study at a single institution and a review of the significance of p53 and p21.
        Ann Surg. 2000; 231: 329-338
        • Nilsson O
        • Lindeberg J
        • Zedenius J
        • et al.
        Anaplastic giant cell carcinoma of the thyroid gland: treatment and survival over a 25-year period.
        World J Surg. 1998; 22: 725-730
        • Shimaoka K.
        There is a benefit from chemotherapy for thyroid cancer.
        Prog Surg. 1988; 19: 163-180
        • Ain KB
        • Tofiq S
        • Taylor KD
        Antineoplastic activity of taxol against human anaplastic thyroid carcinoma cell lines in vitro and in vivo.
        J Clin Endocrinol Metab. 1996; 81: 3650-3653
        • Ain KB
        • Egorin MJ
        • DeSimone PA
        Treatment of anaplastic thyroid carcinoma with paclitaxel: phase 2 trial using ninety-six-hour infusion. The Collaborative Anaplastic Thyroid Cancer Health Intervention Trials (CATCHIT) Group.
        Thyroid. 2000; 10: 587-594