T Ibrahimpasic1, R Ghossein, D L Carlson, I Nixon, F L Palmer, A R Shaha, S G Patel, R M Tuttle, J P Shah, I Ganly. 1. Departments of Head and Neck Surgery (T.I., I.N., F.L.P., A.R.S., S.G.P., J.P.S., I.G.) and Pathology (R.G.), Memorial Sloan-Kettering Cancer Center, New York, New York 10065; Department of Pathology (D.L.C.), Cleveland Clinic, Weston, Florida 33331; and Department of Endocrinology (R.M.T.), Memorial Sloan-Kettering Cancer Center, New York, New York 10065.
Abstract
BACKGROUND: Poorly differentiated thyroid cancer (PDTC) accounts for only 1-15% of all thyroid cancers. Our objective is to report outcomes in a large series of patients with PDTC treated at a single tertiary care cancer center. METHODS: A total of 91 patients with primary PDTC were treated by initial surgery with or without adjuvant therapy at Memorial Sloan-Kettering Cancer Center from 1986 to 2009. Outcomes were calculated by the Kaplan-Meier method. Clinicopathological characteristics were compared for PDTC patients who died of disease to those who did not by the χ(2) test. Factors predictive of disease-specific survival (DSS) were calculated by univariate and multivariate analysis using the log rank and Cox proportional hazards method, respectively. RESULTS: With a median follow-up of 50 months, the 5-year overall survival and DSS were 62 and 66%, respectively. The 5-year locoregional and distant control were 81 and 59%, respectively. Of 27 disease-specific deaths, 23 (85%) were due to distant disease. Age ≥ 45 years, pathological tumor size >4 cm, extrathyroidal extension, higher pathological T stage, positive margins, and distant metastases (M1) were predictive of worse DSS on univariate analysis. Multivariate analysis showed that only pT4a stage and M1 were independent predictors of worse DSS. CONCLUSIONS: With appropriate surgery and adjuvant therapy, excellent locoregional control can be achieved in PDTC. Disease-specific deaths occurred due to distant metastases and rarely due to uncontrolled locoregional recurrence in this series.
BACKGROUND: Poorly differentiated thyroid cancer (PDTC) accounts for only 1-15% of all thyroid cancers. Our objective is to report outcomes in a large series of patients with PDTC treated at a single tertiary care cancer center. METHODS: A total of 91 patients with primary PDTC were treated by initial surgery with or without adjuvant therapy at Memorial Sloan-Kettering Cancer Center from 1986 to 2009. Outcomes were calculated by the Kaplan-Meier method. Clinicopathological characteristics were compared for PDTC patients who died of disease to those who did not by the χ(2) test. Factors predictive of disease-specific survival (DSS) were calculated by univariate and multivariate analysis using the log rank and Cox proportional hazards method, respectively. RESULTS: With a median follow-up of 50 months, the 5-year overall survival and DSS were 62 and 66%, respectively. The 5-year locoregional and distant control were 81 and 59%, respectively. Of 27 disease-specific deaths, 23 (85%) were due to distant disease. Age ≥ 45 years, pathological tumor size >4 cm, extrathyroidal extension, higher pathological T stage, positive margins, and distant metastases (M1) were predictive of worse DSS on univariate analysis. Multivariate analysis showed that only pT4a stage and M1 were independent predictors of worse DSS. CONCLUSIONS: With appropriate surgery and adjuvant therapy, excellent locoregional control can be achieved in PDTC. Disease-specific deaths occurred due to distant metastases and rarely due to uncontrolled locoregional recurrence in this series.
Authors: Laura Fugazzola; Rossella Elisei; Dagmar Fuhrer; Barbara Jarzab; Sophie Leboulleux; Kate Newbold; Jan Smit Journal: Eur Thyroid J Date: 2019-08-28
Authors: Tihana Ibrahimpasic; Bin Xu; Iñigo Landa; Snjezana Dogan; Sumit Middha; Venkatraman Seshan; Shyam Deraje; Diane L Carlson; Jocelyn Migliacci; Jeffrey A Knauf; Brian Untch; Michael F Berger; Luc Morris; R Michael Tuttle; Timothy Chan; James A Fagin; Ronald Ghossein; Ian Ganly Journal: Clin Cancer Res Date: 2017-06-20 Impact factor: 12.531
Authors: Alyaksandr V Nikitski; Susan L Rominski; Vincenzo Condello; Cihan Kaya; Mamta Wankhede; Federica Panebianco; Hong Yang; Daniel L Altschuler; Yuri E Nikiforov Journal: Thyroid Date: 2019-08-16 Impact factor: 6.568
Authors: Bin Xu; Tihana Ibrahimpasic; Laura Wang; Mona M Sabra; Jocelyn C Migliacci; R Michael Tuttle; Ian Ganly; Ronald Ghossein Journal: Thyroid Date: 2016-09-07 Impact factor: 6.568
Authors: Allen S Ho; Michael Luu; Laurel Barrios; Bonnie L Balzer; Shikha Bose; Xuemo Fan; Evan Walgama; Jon Mallen-St Clair; Usman Alam; Iram Shafqat; De-Chen Lin; Yufei Chen; Jennifer E Van Eyk; Ellie G Maghami; Glenn D Braunstein; Wendy L Sacks; Zachary S Zumsteg Journal: Ann Surg Oncol Date: 2020-08-17 Impact factor: 5.344