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The effect of surgery and radiotherapy on outcome of anaplastic thyroid carcinoma

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Abstract

Background: Anaplastic thyroid carcinoma (ATC) is an aggressive rare tumor. We analyzed our experience for prognosis and the effect of surgery and radiotherapy on patients with ATC.

Methods: We conducted a retrospective review of all patients (n=67) with ATC treated at a tertiary care center from 1969 to 1999. Survivor median follow-up was 51 months. Tumor and patient characteristics and therapy were assessed for effect on survival by multivariate analysis.

Results: Patients presented with a neck mass (99%), change of voice (51%), dysphagia (33%), and dyspnea (28%). Surgery was performed in 44 of 67 patients, with 12 complete resections. The 6-month and 1- and 3-year survival rates were 92%, 92%, and 83% after complete resection; 53%, 35%, and 0% after debulking; and 22%, 4%, and 0% after no resection, respectively (P<.0001). A radiation dose of >45 Gy improved survival as compared with a lower dose (P=.02). Multivariate analysis showed that age ≤70 years, absence of dyspnea or dysphagia at presentation, a tumor size ≤5 cm, and any surgical resection improved survival (P<.05).

Conclusions: Candidates for surgery with curative intent for ATC are patients ≤70 years, tumors ≤5 cm, and no distant disease. Radiotherapy >45 Gy improves outcome.

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Authors and Affiliations

  1. Department of Surgery, Division of Surgical Oncology, Massachusetts General Hospital, 626 Cox Building, 100 Blossom St., 02114, Boston, MA

    Randall D. Gaz MD & Mark J. Ott MD

  2. Department of Cancer Statistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

    Alona Muzikansky MA

  3. Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

    William C. Faquin MD, PhD

  4. Department of Surgery, Medical Center Leeuwarden, The Netherlands

    Jean -Pierre E. N. Pierie MD, PhD

Authors
  1. Jean -Pierre E. N. Pierie MD, PhD
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  2. Alona Muzikansky MA
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  3. Randall D. Gaz MD
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  4. William C. Faquin MD, PhD
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  5. Mark J. Ott MD
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Correspondence to Mark J. Ott MD.

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Pierie, J.P.E.N., Muzikansky, A., Gaz, R.D. et al. The effect of surgery and radiotherapy on outcome of anaplastic thyroid carcinoma. Ann Surg Oncol 9, 57–64 (2002). https://doi.org/10.1245/aso.2002.9.1.57

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  • DOI: https://doi.org/10.1245/aso.2002.9.1.57

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