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Anaplastic carcinoma of the thyroid gland: Treatment and outcome over 13 years at one institution

Authors

  • Ivan Segerhammar MSc,

    Corresponding author
    1. Department of Molecular Medicine and Surgery, Section of Endocrine Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
    2. Department of Molecular Medicine and Surgery, Section of Medical Genetics, Karolinska Institutet, Karolinska University Hospital, CMM, Stockholm, Sweden
    • Department of Molecular Medicine and Surgery, Section of Endocrine Surgery, Karolinska Institutet, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. Fax: +46 (0) 8 33 15 87.===

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  • Catharina Larsson MD, PhD,

    1. Department of Molecular Medicine and Surgery, Section of Medical Genetics, Karolinska Institutet, Karolinska University Hospital, CMM, Stockholm, Sweden
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  • Inga-Lena Nilsson MD, PhD,

    1. Department of Molecular Medicine and Surgery, Section of Endocrine Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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  • Martin Bäckdahl MD, PhD,

    1. Department of Molecular Medicine and Surgery, Section of Endocrine Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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  • Anders Höög MD, PhD,

    1. Department of Pathology-Cytology, Karolinska University Hospital, Stockholm, Sweden
    2. Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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  • Göran Wallin MD, PhD,

    1. Department of Surgery, Örebro University Hospital, Örebro, Sweden
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  • Theodoros Foukakis MD, PhD,

    1. Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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  • Jan Zedenius MD, PhD

    1. Department of Molecular Medicine and Surgery, Section of Endocrine Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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Abstract

Background

Anaplastic thyroid carcinoma (ATC) is a highly aggressive malignancy of the thyroid gland. Patients at our institution are treated with external radiotherapy up to 46 Gray (Gy) and low-dose doxorubicin prior to surgery. We retrospectively evaluated the outcome of ATC patients over a 13-year period.

Methods

Clinical, histopathological, and follow-up data for 59 patients diagnosed between 1997 and 2010 were collected and analyzed.

Results

Median age at diagnosis was 77 years. Female-male ratio was 2.5:1. Median survival from time of diagnosis was 3.3 months. Thirty-six patients completed the treatment protocol (including surgery), of whom one succumbed due to local tumor growth. In multivariate analysis, the only factor significantly associated with longer survival among operated patients was absence of metastases at diagnosis (P = 0.031). No impact on survival time was found for gender, extent of surgical resection, and absence of extrathyroidal invasion.

Conclusions

Despite aggressive treatment, survival rates in ATC patients remain low. Locoregional control is feasible for most patients, underscoring the importance of an intense, multimodal treatment regimen. Further oncological intervention is of crucial importance to achieve a better prognosis for ATC patients. J. Surg. Oncol. 2012; 106: 981–986. © 2012 Wiley Periodicals, Inc.

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