Giovanni Conzo1, Andrea Polistena2, Pietro Giorgio Calò3, Paolo Bononi4, Claudio Gambardella5, Claudio Mauriello5, Ernesto Tartaglia5, Stefano Avenia2, Alessandro Sanguinetti2, Fabio Medas3, Giorgio de Toma4, Nicola Avenia2. 1. Department of Anaesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen. G. Orsini 42, 80132 Napoli, Italy. Electronic address: giovanni.conzo@unina2.it. 2. University of Perugia, Medical School, General Surgery and Surgical Specialties Unit, S. Maria University Hospital, Terni, Italy. 3. Department of Surgical Sciences, University of Cagliari, Italy. 4. Department of Surgery "P. Valdoni", University of Rome "La Sapienza" Policlinico Umberto I, Italy. 5. Department of Anaesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen. G. Orsini 42, 80132 Napoli, Italy.
Abstract
INTRODUCTION: Anaplastic thyroid carcinoma (ATC) is a killer tumor, characterized by local invasiveness, risk of recurrence and very poor prognosis. Due to its rarity, clinical case studies concerning management are lacking. METHODS: We retrospectively reviewed a multinstitutional clinical series of 114 consecutive patients treated between 1996 and 2012 for ATC. The outcomes of a combined treatment were analyzed considering the impact of surgery and radiotherapy on survival. RESULTS: Patients were divided in groups A and B considering tumor size (tumor lesser and larger than 5 cm). Surgery was carried out in 71 patients, radiotherapy in 89 patients. Tracheostomy and endoprothesis were used respectively in 48.7% and in 25.6% of patients. The mean survival was 5.35 (±3.2) months with no significant difference in group A vs group B. A better survival was observed in both groups of patients undergone a surgical treatment compared to no treated patients (p = 0.001 and p = 0.0001) or to patients undergone radiotherapy alone (p = 0.047 and p = 0.0001). Combination of surgery and radiotherapy significantly improved outcome (p = 0.017). DISCUSSION: Despite disappointing results from single therapeutic approach, multimodal strategy has progressively become the treatment of choice in ATC, with surgery being the cornerstone of the management. CONCLUSION: Although dismal prognosis, the combined treatment might significantly improves locoregional disease control, achieving acceptable survival in selected patients and adequate palliation of the symptoms.
INTRODUCTION:Anaplastic thyroid carcinoma (ATC) is a killer tumor, characterized by local invasiveness, risk of recurrence and very poor prognosis. Due to its rarity, clinical case studies concerning management are lacking. METHODS: We retrospectively reviewed a multinstitutional clinical series of 114 consecutive patients treated between 1996 and 2012 for ATC. The outcomes of a combined treatment were analyzed considering the impact of surgery and radiotherapy on survival. RESULTS:Patients were divided in groups A and B considering tumor size (tumor lesser and larger than 5 cm). Surgery was carried out in 71 patients, radiotherapy in 89 patients. Tracheostomy and endoprothesis were used respectively in 48.7% and in 25.6% of patients. The mean survival was 5.35 (±3.2) months with no significant difference in group A vs group B. A better survival was observed in both groups of patients undergone a surgical treatment compared to no treated patients (p = 0.001 and p = 0.0001) or to patients undergone radiotherapy alone (p = 0.047 and p = 0.0001). Combination of surgery and radiotherapy significantly improved outcome (p = 0.017). DISCUSSION: Despite disappointing results from single therapeutic approach, multimodal strategy has progressively become the treatment of choice in ATC, with surgery being the cornerstone of the management. CONCLUSION: Although dismal prognosis, the combined treatment might significantly improves locoregional disease control, achieving acceptable survival in selected patients and adequate palliation of the symptoms.
Authors: Giovanni Conzo; Ernesto Tartaglia; Nicola Avenia; Pier Giorgio Calò; Annamaria de Bellis; Katherine Esposito; Claudio Gambardella; Sergio Iorio; Daniela Pasquali; Luigi Santini; Maria Antonia Sinisi; Antonio Agostino Sinisi; Mario Testini; Andrea Polistena; Giuseppe Bellastella Journal: World J Surg Oncol Date: 2016-05-17 Impact factor: 2.754
Authors: Jie Li; Ling Bo Xue; Xiao Yi Gong; Yan Fang Yang; Bu Yong Zhang; Jian Jin; Qing Feng Shi; Yong Hong Liu Journal: Cancer Manag Res Date: 2019-12-19 Impact factor: 3.989