Iustina Cosmina Mogos1, Dan Alexandru Niculescu2, Dumitru Ioachim3, Radu Iorgulescu4, Catalina Poiana2. 1. Department of Pituitary and Neuroendocrine Disorders, "C. I. Parhon" Institute of Endocrinology, Bucharest, Romania. 2. Department of Endocrinology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania. 3. Department of Pathology, "C. I. Parhon" Institute of Endocrinology, Bucharest, Romania. 4. Department of Surgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Abstract
AIM: Anaplastic thyroid carcinoma (ATC), poorly differentiated thyroid carcinoma (PTDC) and lymphoma are aggressive forms of neoplasia. Although all carry a poor prognosis there is an important heterogeneity of overall survival (OS) between individual patients. The decision of total thyroidectomy is often based on fine-needle aspiration biopsy (FNAB) which has important limitations in this setting. Our aim was to assess the OS of aggressive thyroid cancer diagnosed on FNAB in a single university center. METHODS: We retrospectively reviewed all the ATC, PDTC and lymphoma cases diagnosed on FNAB during 2007-2013 (15 cases). All FNAB examinations were performed by the same specialized pathologist. Data on demographics, laboratory tests, imaging studies, FNAB/pathology reports, treatment and survival time were recorded. All patients had serum calcitonin levels under 5 pg/mL. Five patients had total thyroidectomy. RESULTS: The OS was 2.2 (0.6, 18.5) months. The survival rate at 3 and 12 months was 46.6% and 33.3% respectively. There were no significant differences between ATC and PDTC/lymphoma patients for age, TSH, largest tumoral diameter and cervical lymph involvement. Patients with ATC (8 cases) had a median OS of 0.8 months, significantly shorter than 6 months for patients with PDTC/lymphoma (7 cases). Patients treated with total thyroidectomy had a median OS of 20 months compared with 1.87 months for patients without surgical intervention (p=0.06). CONCLUSIONS: The differences between groups and the heterogeneity of individual cases suggest that a diagnosis of aggressive thyroid cancer on FNAB should not preclude the surgical intervention. The decision to operate should be based on accurate imaging rather than on discouraging FNAB result.
AIM: Anaplastic thyroid carcinoma (ATC), poorly differentiated thyroid carcinoma (PTDC) and lymphoma are aggressive forms of neoplasia. Although all carry a poor prognosis there is an important heterogeneity of overall survival (OS) between individual patients. The decision of total thyroidectomy is often based on fine-needle aspiration biopsy (FNAB) which has important limitations in this setting. Our aim was to assess the OS of aggressive thyroid cancer diagnosed on FNAB in a single university center. METHODS: We retrospectively reviewed all the ATC, PDTC and lymphoma cases diagnosed on FNAB during 2007-2013 (15 cases). All FNAB examinations were performed by the same specialized pathologist. Data on demographics, laboratory tests, imaging studies, FNAB/pathology reports, treatment and survival time were recorded. All patients had serum calcitonin levels under 5 pg/mL. Five patients had total thyroidectomy. RESULTS: The OS was 2.2 (0.6, 18.5) months. The survival rate at 3 and 12 months was 46.6% and 33.3% respectively. There were no significant differences between ATC and PDTC/lymphomapatients for age, TSH, largest tumoral diameter and cervical lymph involvement. Patients with ATC (8 cases) had a median OS of 0.8 months, significantly shorter than 6 months for patients with PDTC/lymphoma (7 cases). Patients treated with total thyroidectomy had a median OS of 20 months compared with 1.87 months for patients without surgical intervention (p=0.06). CONCLUSIONS: The differences between groups and the heterogeneity of individual cases suggest that a diagnosis of aggressive thyroid cancer on FNAB should not preclude the surgical intervention. The decision to operate should be based on accurate imaging rather than on discouraging FNAB result.
Authors: H Asakawa; T Kobayashi; Y Komoike; H Maruyama; Y Nakano; Y Tamaki; Y Matsuzawa; M Monden Journal: Anticancer Res Date: 1997 Jul-Aug Impact factor: 2.480
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Authors: Robert C Smallridge; Kenneth B Ain; Sylvia L Asa; Keith C Bible; James D Brierley; Kenneth D Burman; Electron Kebebew; Nancy Y Lee; Yuri E Nikiforov; M Sara Rosenthal; Manisha H Shah; Ashok R Shaha; R Michael Tuttle Journal: Thyroid Date: 2012-11 Impact factor: 6.568