Julia Wendler1, Matthias Kroiss2, Katja Gast3, Michael C Kreissl4, Stephanie Allelein5, Urs Lichtenauer6, Rainer Blaser7, Christine Spitzweg3, Martin Fassnacht8, Matthias Schott6, Dagmar Führer9, Vera Tiedje10. 1. Department of Internal Medicine IDivision of Endocrinology and Diabetes, University of Würzburg, University Hospital Würzburg, Würzburg, Germany. 2. Department of Internal Medicine IDivision of Endocrinology and Diabetes, University of Würzburg, University Hospital Würzburg, Würzburg, Germany Kroiss_M@ukw.de vera.tiedje@uk-essen.de. 3. Department of Internal Medicine IIUniversity Hospital Munich, Ludwig-Maximilians-Universität Munich, München, Germany. 4. Department of Nuclear MedicineCentral Hospital Augsburg, Augsburg, Germany. 5. Division for Specific EndocrinologyUniversity Hospital Düsseldorf, Düsseldorf, Germany. 6. Department of Internal Medicine IVUniversity Hospital Munich, Ludwig-Maximilians-Universität München, München, Germany. 7. Technical University MunichKlinikum rechts der Isar, Institute for Medical Statistics and Epidemiology, München, Germany. 8. University of WürzburgComprehensive Cancer Center, Würzburg, Germany. 9. Department of Endocrinology and MetabolismUniversity Hospital Essen, University Duisburg-Essen, Essen, Germany. 10. Department of Endocrinology and MetabolismUniversity Hospital Essen, University Duisburg-Essen, Essen, Germany Kroiss_M@ukw.de vera.tiedje@uk-essen.de.
Abstract
CONTEXT: Anaplastic thyroid carcinoma (ATC) is an orphan disease and confers a dismal prognosis. Standard treatment is not established. OBJECTIVE: The aim of this study is to describe clinical characteristics, current treatment regimens and outcome of ATC and to identify clinical prognostic markers and treatment factors associated with improved prognosis. DESIGN: Retrospective cohort study at five German tertiary care centers. PATIENTS AND METHODS: Totally 100 ATC patients diagnosed between 2000 and 2015 were included in the analysis. Disease-specific overall survival (OS) was compared with the Kaplan-Meier method and log-rank test; Cox proportional hazard model was used to identify risk factors. RESULTS: The 6-month, 1-year and 5-year disease-specific OS rates were 37, 28 and 5%, respectively. Stage-dependent OS at 6 months was 78, 54 and 18% for stage IVA, B and C, respectively. 29% patients survived >1 year. Multivariate analysis of OS identified age ≥70 years, incomplete local resection status and the presence of distant metastasis as significant risk factors associated with shorter survival. Radical surgery (hazard ratio [HR] 2.20, 95% confidence interval (CI) 1.19-4.09, P = 0.012), external beam radiation therapy (EBRT) ≥40 Gy (HR = 0.34, 0.15-0.76, P = 0.008) and any kind of chemotherapy (CTX) (HR = 11.64, 2.42-60.39, P = 0.003) were associated with longer survival in multivariate analyses adjusted for age and tumor stage. A multimodal treatment regimen was significantly associated with a survival benefit (HR = 1.04, 1.01-1.08, P < 0.0001) only in IVC patients. CONCLUSION: Disease-specific OS is still poor in ATC. Treatment factors associated with improved OS provide a rationale to devise treatment pathways for routine care. Collaborative research structures should be aimed to advance treatment of ATC.
CONTEXT: Anaplastic thyroid carcinoma (ATC) is an orphan disease and confers a dismal prognosis. Standard treatment is not established. OBJECTIVE: The aim of this study is to describe clinical characteristics, current treatment regimens and outcome of ATC and to identify clinical prognostic markers and treatment factors associated with improved prognosis. DESIGN: Retrospective cohort study at five German tertiary care centers. PATIENTS AND METHODS: Totally 100 ATC patients diagnosed between 2000 and 2015 were included in the analysis. Disease-specific overall survival (OS) was compared with the Kaplan-Meier method and log-rank test; Cox proportional hazard model was used to identify risk factors. RESULTS: The 6-month, 1-year and 5-year disease-specific OS rates were 37, 28 and 5%, respectively. Stage-dependent OS at 6 months was 78, 54 and 18% for stage IVA, B and C, respectively. 29% patients survived >1 year. Multivariate analysis of OS identified age ≥70 years, incomplete local resection status and the presence of distant metastasis as significant risk factors associated with shorter survival. Radical surgery (hazard ratio [HR] 2.20, 95% confidence interval (CI) 1.19-4.09, P = 0.012), external beam radiation therapy (EBRT) ≥40 Gy (HR = 0.34, 0.15-0.76, P = 0.008) and any kind of chemotherapy (CTX) (HR = 11.64, 2.42-60.39, P = 0.003) were associated with longer survival in multivariate analyses adjusted for age and tumor stage. A multimodal treatment regimen was significantly associated with a survival benefit (HR = 1.04, 1.01-1.08, P < 0.0001) only in IVCpatients. CONCLUSION: Disease-specific OS is still poor in ATC. Treatment factors associated with improved OS provide a rationale to devise treatment pathways for routine care. Collaborative research structures should be aimed to advance treatment of ATC.
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: Sabine Wächter; C Vorländer; J Schabram; I Mintziras; I Fülber; J Manoharan; K Holzer; D K Bartsch; E Maurer Journal: Eur Arch Otorhinolaryngol Date: 2020-02-14 Impact factor: 2.503
Authors: Christine Dierks; Jochen Seufert; Konrad Aumann; Juri Ruf; Claudius Klein; Selina Kiefer; Michael Rassner; Melanie Boerries; Andreas Zielke; Paul la Rosee; Philipp Tobias Meyer; Matthias Kroiss; Christian Weißenberger; Tilmann Schumacher; Patrick Metzger; Harald Weiss; Constantin Smaxwil; Katharina Laubner; Justus Duyster; Nikolas von Bubnoff; Cornelius Miething; Oliver Thomusch Journal: Thyroid Date: 2021-04-15 Impact factor: 6.568