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Poorly differentiated thyroid carcinoma (PDTC) characteristics and the efficacy of radioactive iodine (RAI) therapy as an adjuvant treatment in a tertiary cancer care center

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Abstract

Background

Poorly differentiated thyroid cancer (PDTC) is biologically more aggressive. Surgery remains the mainstay of treatment. The utility of radioactive iodine (RAI) after surgery is unclear.

Methods

In this retrospective study, patients treated between Jan 2012 and Dec 2017 were included. The demographic, clinical and treatment-related details, including RAI ablation, were recorded and their survival analyzed.

Results

Thirty-five patients fulfilled the eligibility criteria. Majority was treatment naïve at presentation. All patients underwent surgery followed by RAI ablation, with a cumulative median dose of 220 mCi (range 40–1140). Sixteen patients received more than one radioiodine treatment for distant metastases. Incomplete resection, age > 45 years and the presence of distant metastasis influenced survival the most. The 3-year PFS of patients with PDTC was 69%.

Conclusion

All patients in our series showed uptake and responded to treatment. Further use of molecular markers and functional molecular imaging would better our understanding of this entity.

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References

  1. Lin JD, Chao TC, Hsueh C (2007) Clinical characteristics of poorly differentiated thyroid carcinomas compared with those of classical papillary thyroid carcinomas. Clin Endocrinol 66:224–228

    Article  Google Scholar 

  2. Sakamoto A, Kasai N, Sugano H (1983) Poorly differentiated carcinoma of the thyroid. A clinicopathologic entity for a high-risk group of papillary and follicular carcinomas. Cancer 52:1849–1855

    Article  CAS  Google Scholar 

  3. Carcangiu ML, Zamp G, Rosai J (1984) Poorly differentiated (“insular”) thyroid carcinoma. A reinterpretation of Langhans’ “wuchernde Struma”. Am J Surg Pathol 8:655–668

    Article  CAS  Google Scholar 

  4. DeLellis RA, World Health Organization, International Agency for Research on Cancer (2004) Pathology and genetics of tumours of endocrine organs. 3rd ed. Lyon: IARC Press, Chapter 2, Poorly differentiated carcinoma, p. 73–6.

  5. Volante M, Collini P, Nikiforov YE, Sobrinho-simoes M, Kakudo K, Katoh R et al (2007) Poorly differentiated thyroid carcinoma: the turin proposal for the use of uniform diagnostic criteria and an algorithmic diagnostic approach. Am J Surg Pathol 31(8):1256–1264

    Article  Google Scholar 

  6. Xu B, Ibrahimpasic T, Wang L, Sabra MM, Migliacci JC, Tuttle RM et al (2016) Clinicopathologic features of fatal non-anaplastic follicular cell-derived thyroid carcinomas. Thyroid 26(11):1588–1597

    Article  CAS  Google Scholar 

  7. Andresen NS, Buatti JM, Tewfik HH, Pagedar NA, Anderson CM, Watkins JM (2017) Radioiodine ablation following thyroidectomy for differentiated thyroid cancer: literature review of utility, dose, and toxicity. Eur Thyroid J 6(4):187–196

    Article  CAS  Google Scholar 

  8. Sanders EM Jr, LiVolsi VA, Brierley J, Shin J, Randolph GW (2007) An evidence-based review of poorly differentiated thyroid cancer. World J Surg 31(5):934–945

    Article  Google Scholar 

  9. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ et al (2009) Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19:1167–1214

    Article  Google Scholar 

  10. Sadow PM, Faquin WC (2012) Poorly differentiated thyroid carcinoma: an incubating entity. Front Endocrinol (Lausanne) 3:77

    Google Scholar 

  11. Hiltzik D, Carlson DL, Tuttle RM, Chuai S, Ishill N, Shaha A et al (2006) Poorly differentiated thyroid carcinomas defined on the basis of mitosis and necrosis: a clinicopathologic study of 58 patients. Cancer 106(6):1286–1295

    Article  Google Scholar 

  12. Yu MG, Rivera J, Jimeno C (2017) Poorly differentiated thyroid carcinoma: 10-year experience in a southeast asian population. Endocrinol Metab 32:288–295

    Article  Google Scholar 

  13. Ibrahimpasic T, Ghossein R, Carlson DL, Nixon I, Palmer FL, Shaha AR et al (2014) Outcomes in patients with poorly differentiated thyroid carcinoma. J Clin Endocrinol Metab 99:1245–1252

    Article  CAS  Google Scholar 

  14. Cherkaoui GS, Guensi A, Taleb S, Idir MA, Touil N, Benmoussa R et al (2015) Poorly differentiated thyroid carcinoma: a retrospective clinicopathological study. Pan Afr Med J 21:137

    Article  Google Scholar 

  15. Tanaka K, Sonoo H, Saito W, Ohta Y, Shimo T, Sohda M et al (2011) Analysis of clinical outcome of patients with poorly differentiated thyroid carcinoma. ISRN Endocrinol 2011:308029

    Article  Google Scholar 

  16. Volante M, Landolfi S, Chiusa L, Palestini N, Motta M, Codegone A et al (2004) Poorly differentiated carcinomas of the thyroid with trabecular, insular, and solid patterns: a clinicopathologic study of 183 patients. Cancer 100:950–957

    Article  Google Scholar 

  17. Saglietti C, Onenerk AM, Faquin WC, Sykiotis GP, Ziadi S, Bongiovanni M (2017) FNA diagnosis of poorly differentiated thyroid carcinoma. A review of the recent literature. Cytopathology 28(6):467–474

    Article  CAS  Google Scholar 

  18. Kane SV, Sharma TP (2015) Cytologic diagnostic approach to poorly differentiated thyroid carcinoma: a single-institution study. Cancer Cytopathol 123(2):82–91

    Article  Google Scholar 

  19. Jung TS, Kim TY, Kim KW, Oh YL, Park DJ, Cho BY et al (2007) Clinical features and prognostic factors for survival in patients with poorly differentiated thyroid carcinoma and comparison to the patients with the aggressive variants of papillary thyroid carcinoma. Endocr J 54:265–274

    Article  Google Scholar 

  20. Nunes da Silva T, Limbert E, Leite V (2018) Poorly differentiated thyroid carcinoma patients with detectable thyroglobulin levels after initial treatment show an increase in mortality and disease recurrence. Eur Thyroid J 7(6):313–318

    Article  CAS  Google Scholar 

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Acknowledgements

I would like to acknowledge Dr. Manish Mair and Dr. Burhanuddin N Qayyumi for their contribution toward this study and Atanu Bhatacharjee, Section of Biostatistics, Centre for Cancer Epidemiology, Homi Bhabha National Institute (HBNI), Tata Memorial Centre, Mumbai, Maharashtra, India.

Funding

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Authors and Affiliations

Authors

Contributions

Study concepts: ST, DC, DN. Study design: ST, HD, DN. Data acquisition: AY, YM, RS, HD. Quality control of data and algorithms: ST, AP, SK. Statistical analysis: AB, ST. Manuscript preparation: ST, HD, SGL, SB, DC. Manuscript editing: ST, SGL, SB, DC. Manuscript reviewing: all authors.

Corresponding author

Correspondence to Shivakumar Thiagarajan.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Institute ethical committee clearance was taken for this study (Approval number: IEC/1219/3314/001, Project number-3314). All patients received the standard of care for their condition as per the ethical standards.

Informed consent

No identifying information about participants is available in the article. However, all patients have given consent for the treatment they have received.

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Thiagarajan, S., Yousuf, A., Shetty, R. et al. Poorly differentiated thyroid carcinoma (PDTC) characteristics and the efficacy of radioactive iodine (RAI) therapy as an adjuvant treatment in a tertiary cancer care center. Eur Arch Otorhinolaryngol 277, 1807–1814 (2020). https://doi.org/10.1007/s00405-020-05898-9

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  • DOI: https://doi.org/10.1007/s00405-020-05898-9

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