Gitte Bjørn Hvilsom1, Stefano Christian Londero2, Christoffer Holst Hahn3, Sten Schytte4, Henrik Baymler Pedersen5, Peer Christiansen6, Katalin Kiss7, Stine Rosenkilde Larsen8, Marie Louise Jespersen9, Giedrius Lelkaitis10, Christian Godballe11. 1. Odense University Hospital, Department of ENT, Head & Neck Surgery, Sdr Boulevard 29, 5000 Odense C, Denmark. Electronic address: Gibj@regionsjaelland.dk. 2. Odense University Hospital, Department of ENT, Head & Neck Surgery, Sdr Boulevard 29, 5000 Odense C, Denmark; Aarhus University Hospital, Department of ENT Head & Neck Surgery, Nørrebrogade 44, 8000 Aarhus C, Denmark. Electronic address: Stelon@rm.dk. 3. Copenhagen University Hospital, Rigshospitalet, Department of ENT Head & Neck Surgery, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark. Electronic address: Christoffer.Holst.Hahn.01@regionh.dk. 4. Aarhus University Hospital, Department of ENT Head & Neck Surgery, Nørrebrogade 44, 8000 Aarhus C, Denmark. Electronic address: sten.schytte@aarhus.rm.dk. 5. Aalborg University Hospital, Syd, Department of ENT Head & Neck Surgery, Hobrovej 18-22, 9000 Aalborg, Denmark. Electronic address: hebp@rn.dk. 6. Aarhus University Hospital, Department of Surgery, Tage-Hansens Gade 2, 8000 Aarhus C, Denmark. Electronic address: Peerchri@rm.dk. 7. Copenhagen University Hospital, Rigshospitalet, Department of Pathology, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark. Electronic address: katalin.kiss@regionh.dk. 8. Odense University Hospital, Department of Pathology, Sdr Boulevard 29, 5000 Odense C, Denmark. Electronic address: Rosenkilde.Larsen@rsyd.dk. 9. Aarhus University Hospital, Department of Pathology, Tage-Hansens Gade 2, 8000 Aarhus C, Denmark. Electronic address: Marie.jespersen@aarhus.rm.dk. 10. Aalborg University Hospital, Nord, Department of Pathology, Ladegårdsgade 3, 9000 Aalborg, Denmark. Electronic address: Giedrius.lelkaitis@rn.dk. 11. Odense University Hospital, Department of ENT, Head & Neck Surgery, Sdr Boulevard 29, 5000 Odense C, Denmark. Electronic address: Christian.Godballe@rsyd.dk.
Abstract
BACKGROUND: Anaplastic thyroid carcinoma (ATC) is the least common but most malignant thyroid cancer. We aimed to examine the characteristics as well as evaluate the incidence, prognostic factors, and if introduction of a fast track cancer program might influence survival in a cohort of ATC patients. METHODS: A cohort study based on prospective data from the national Danish thyroid cancer database DATHYRCA and the national Danish Pathology Register including 219 patients diagnosed from 1996 to 2012, whom were followed until death or through September 2014. RESULTS: We found the median age in the 7th decade, the majority of patients being women presenting with a growing mass at the neck, diagnosed with stage T4b disease. At diagnosis, 56% of the patients had lymph node metastasis and 38% distant metastasis. We observed one- and five-year survival of 20.7% and 11.0%, respectively. Both univariate and multivariate analyses showed age (above 73.6 years), respiratory impairment, T4b stage, and distant metastasis at diagnosis to be significant prognostic factors. Further, introduction of a national fast track cancer program increased survival nearly two-fold. CONCLUSION: As new information, our study adds "respiratory impairment at diagnosis" and "introduction of a national fast track cancer program" to the list of already established prognostic indicators for ATC.
BACKGROUND:Anaplastic thyroid carcinoma (ATC) is the least common but most malignant thyroid cancer. We aimed to examine the characteristics as well as evaluate the incidence, prognostic factors, and if introduction of a fast track cancer program might influence survival in a cohort of ATC patients. METHODS: A cohort study based on prospective data from the national Danish thyroid cancer database DATHYRCA and the national Danish Pathology Register including 219 patients diagnosed from 1996 to 2012, whom were followed until death or through September 2014. RESULTS: We found the median age in the 7th decade, the majority of patients being women presenting with a growing mass at the neck, diagnosed with stage T4b disease. At diagnosis, 56% of the patients had lymph node metastasis and 38% distant metastasis. We observed one- and five-year survival of 20.7% and 11.0%, respectively. Both univariate and multivariate analyses showed age (above 73.6 years), respiratory impairment, T4b stage, and distant metastasis at diagnosis to be significant prognostic factors. Further, introduction of a national fast track cancer program increased survival nearly two-fold. CONCLUSION: As new information, our study adds "respiratory impairment at diagnosis" and "introduction of a national fast track cancer program" to the list of already established prognostic indicators for ATC.
Authors: Bin Xu; Talia Fuchs; Snjezana Dogan; Iñigo Landa; Nora Katabi; James A Fagin; R Michael Tuttle; Eric Sherman; Anthony J Gill; Ronald Ghossein Journal: Thyroid Date: 2020-05-08 Impact factor: 6.568