Annals of Surgical Oncology

, Volume 9, Issue 1, pp 57–64 | Cite as

The effect of surgery and radiotherapy on outcome of anaplastic thyroid carcinoma

  • Jean -Pierre E. N. Pierie
  • Alona Muzikansky
  • Randall D. Gaz
  • William C. Faquin
  • Mark J. Ott
Original Articles

Abstract

Background: Anaplastic thyroid carcinoma (ATC) is an aggressive rare tumor. We analyzed our experience for prognosis and the effect of surgery and radiotherapy on patients with ATC.

Methods: We conducted a retrospective review of all patients (n=67) with ATC treated at a tertiary care center from 1969 to 1999. Survivor median follow-up was 51 months. Tumor and patient characteristics and therapy were assessed for effect on survival by multivariate analysis.

Results: Patients presented with a neck mass (99%), change of voice (51%), dysphagia (33%), and dyspnea (28%). Surgery was performed in 44 of 67 patients, with 12 complete resections. The 6-month and 1- and 3-year survival rates were 92%, 92%, and 83% after complete resection; 53%, 35%, and 0% after debulking; and 22%, 4%, and 0% after no resection, respectively (P<.0001). A radiation dose of >45 Gy improved survival as compared with a lower dose (P=.02). Multivariate analysis showed that age ≤70 years, absence of dyspnea or dysphagia at presentation, a tumor size ≤5 cm, and any surgical resection improved survival (P<.05).

Conclusions: Candidates for surgery with curative intent for ATC are patients ≤70 years, tumors ≤5 cm, and no distant disease. Radiotherapy >45 Gy improves outcome.

Key Words

Anaplastic thyroid cancer Surgery Radiotherapy Debulking 

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Copyright information

© The Society of Surgical Oncology, Inc. 2002

Authors and Affiliations

  • Jean -Pierre E. N. Pierie
    • 4
  • Alona Muzikansky
    • 2
  • Randall D. Gaz
    • 1
  • William C. Faquin
    • 3
  • Mark J. Ott
    • 1
  1. 1.Department of Surgery, Division of Surgical OncologyMassachusetts General HospitalBoston
  2. 2.Department of Cancer Statistics CenterMassachusetts General Hospital, Harvard Medical SchoolBoston
  3. 3.Department of PathologyMassachusetts General Hospital, Harvard Medical SchoolBoston
  4. 4.Department of SurgeryMedical Center LeeuwardenThe Netherlands

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