Skip to main content
SpringerLink
Log in

First-Line Therapy for Anaplastic Thyroid Cancer: Operation Versus Medical Management

  • Chapter
  • First Online:
Difficult Decisions in Endocrine Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

  • 678 Accesses

Abstract

Anaplastic thyroid cancer (ATC) is a highly lethal disease. First-line therapy for a patient diagnosed with this disease includes surgical resection or chemoradiation. Due to variable treatment and its rarity, there is a paucity of prospective and/or randomized controlled literature studying the initial therapy for patients diagnosed with ATC. To understand which therapy is more appropriate in terms of survival and quality of life, we evaluated the available literature and our own institutional experience with the management of ATC for recommendations regarding this topic. This chapter provides a summary of the pertaining literature and offers recommendations based on these sources for first-line management of a patient with newly diagnosed ATC.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Smallridge RC, Copland JA. Anaplastic thyroid carcinoma: pathogenesis and emerging therapies. Clin Oncol (R Coll Radiol). 2010;22(6):486–97.

    Article  CAS  Google Scholar 

  2. Keutgen XM, Sadowski SM, Kebebew E. Management of anaplastic thyroid cancer. Gland Surg. 2015;4(1):44–51.

    PubMed  PubMed Central  Google Scholar 

  3. Derbel O, Limem S, Segura-Ferlay C, Lifante JC, Carrie C, Peix JL, et al. Results of combined treatment of anaplastic thyroid carcinoma (ATC). BMC Cancer. 2011;11:469.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Savvides P, Nagaiah G, Lavertu P, Fu P, Wright JJ, Chapman R, et al. Phase II trial of sorafenib in patients with advanced anaplastic carcinoma of the thyroid. Thyroid. 2013;23(5):600–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Kebebew E, Greenspan FS, Clark OH, Woeber KA, McMillan A. Anaplastic thyroid carcinoma. Treatment outcome and prognostic factors. Cancer. 2005;103(7):1330–5.

    Article  PubMed  Google Scholar 

  6. Kim TY, Kim KW, Jung TS, Kim JM, Kim SW, Chung KW, et al. Prognostic factors for Korean patients with anaplastic thyroid carcinoma. Head Neck. 2007;29(8):765–72.

    Article  PubMed  Google Scholar 

  7. Kobayashi T, Asakawa H, Umeshita K, Takeda T, Maruyama H, Matsuzuka F, et al. Treatment of 37 patients with anaplastic carcinoma of the thyroid. Head Neck. 1996;18(1):36–41.

    Article  CAS  PubMed  Google Scholar 

  8. Pierie JP, Muzikansky A, Gaz RD, Faquin WC, Ott MJ. The effect of surgery and radiotherapy on outcome of anaplastic thyroid carcinoma. Ann Surg Oncol. 2002;9(1):57–64.

    Article  PubMed  Google Scholar 

  9. Besic N, Hocevar M, Zgajnar J, Pogacnik A, Grazio-Frkovic S, Auersperg M. Prognostic factors in anaplastic carcinoma of the thyroid-a multivariate survival analysis of 188 patients. Langenbecks Arch Surg. 2005;390(3):203–8.

    Article  PubMed  Google Scholar 

  10. Ito K, Hanamura T, Murayama K, Okada T, Watanabe T, Harada M, et al. Multimodality therapeutic outcomes in anaplastic thyroid carcinoma: improved survival in subgroups of patients with localized primary tumors. Head Neck. 2012;34(2):230–7.

    Article  PubMed  Google Scholar 

  11. Besic N, Gazic B. Sites of metastases of anaplastic thyroid carcinoma: autopsy findings in 45 cases from a single institution. Thyroid. 2013;23(6):709–13.

    Article  PubMed  Google Scholar 

  12. Kihara M, Miyauchi A, Yamauchi A, Yokomise H. Prognostic factors of anaplastic thyroid carcinoma. Surg Today. 2004;34(5):394–8.

    Article  PubMed  Google Scholar 

  13. Smallridge RC. Approach to the patient with anaplastic thyroid carcinoma. J Clin Endocrinol Metab. 2012;97(8):2566–72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Smallridge RC, Ain KB, Asa SL, Bible KC, Brierley JD, Burman KD, et al. American Thyroid Association guidelines for management of patients with anaplastic thyroid cancer. Thyroid. 2012;22(11):1104–39.

    Article  PubMed  Google Scholar 

  15. Passler C, Scheuba C, Prager G, Kaserer K, Flores JA, Vierhapper H, et al. Anaplastic (undifferentiated) thyroid carcinoma (ATC). A retrospective analysis. Langenbecks Arch Surg. 1999;384(3):284–93.

    Article  CAS  PubMed  Google Scholar 

  16. Haigh PI, Ituarte PH, Wu HS, Treseler PA, Posner MD, Quivey JM, et al. Completely resected anaplastic thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival. Cancer. 2001;91(12):2335–42.

    Article  CAS  PubMed  Google Scholar 

  17. Akaishi J, Sugino K, Kitagawa W, Nagahama M, Kameyama K, Shimizu K, et al. Prognostic factors and treatment outcomes of 100 cases of anaplastic thyroid carcinoma. Thyroid. 2011;21(11):1183–9.

    Article  PubMed  Google Scholar 

  18. Swaak-Kragten AT, de Wilt JH, Schmitz PI, Bontenbal M, Levendag PC. Multimodality treatment for anaplastic thyroid carcinoma--treatment outcome in 75 patients. Radiother Oncol. 2009;92(1):100–4.

    Article  PubMed  Google Scholar 

  19. Tan RK, Finley RK 3rd, Driscoll D, Bakamjian V, Hicks WL Jr, Shedd DP. Anaplastic carcinoma of the thyroid: a 24-year experience. Head Neck. 1995;17(1):41–7. discussion 7–8.

    Article  CAS  PubMed  Google Scholar 

  20. Zhang ZM, Xu ZG, Tang PZ, Xue LY, Lu N. A retrospective analysis of anaplastic thyroid carcinoma. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2006;28(3):322–4.

    PubMed  Google Scholar 

  21. Holting T, Meybier H, Buhr H. Problems of tracheotomy in locally invasive anaplastic thyroid cancer. Langenbecks Arch Chir. 1989;374(2):72–6.

    Article  CAS  PubMed  Google Scholar 

  22. Holting T, Meybier H, Buhr H. Status of tracheotomy in treatment of the respiratory emergency in anaplastic thyroid cancer. Wien Klin Wochenschr. 1990;102(9):264–6.

    PubMed  CAS  Google Scholar 

  23. Shaha AR. Airway management in anaplastic thyroid carcinoma. Laryngoscope. 2008;118(7):1195–8.

    Article  PubMed  Google Scholar 

  24. Wein RO, Weber RS. Anaplastic thyroid carcinoma: palliation or treatment? Curr Opin Otolaryngol Head Neck Surg. 2011;19(2):113–8.

    Article  PubMed  Google Scholar 

  25. Wang Y, Tsang R, Asa S, Dickson B, Arenovich T, Brierley J. Clinical outcome of anaplastic thyroid carcinoma treated with radiotherapy of once- and twice-daily fractionation regimens. Cancer. 2006;107(8):1786–92.

    Article  PubMed  Google Scholar 

  26. Levendag PC, De Porre PM, van Putten WL. Anaplastic carcinoma of the thyroid gland treated by radiation therapy. Int J Radiat Oncol Biol Phys. 1993;26(1):125–8.

    Article  CAS  PubMed  Google Scholar 

  27. Sherman EJ, Lim SH, Ho AL, Ghossein RA, Fury MG, Shaha AR, et al. Concurrent doxorubicin and radiotherapy for anaplastic thyroid cancer: a critical re-evaluation including uniform pathologic review. Radiother Oncol. 2011;101(3):425–30.

    Article  CAS  PubMed  Google Scholar 

  28. Nutting CM, Convery DJ, Cosgrove VP, Rowbottom C, Vini L, Harmer C, et al. Improvements in target coverage and reduced spinal cord irradiation using intensity-modulated radiotherapy (IMRT) in patients with carcinoma of the thyroid gland. Radiother Oncol. 2001;60(2):173–80.

    Article  CAS  PubMed  Google Scholar 

  29. Posner MD, Quivey JM, Akazawa PF, Xia P, Akazawa C, Verhey LJ. Dose optimization for the treatment of anaplastic thyroid carcinoma: a comparison of treatment planning techniques. Int J Radiat Oncol Biol Phys. 2000;48(2):475–83.

    Article  CAS  PubMed  Google Scholar 

  30. Dandekar P, Harmer C, Barbachano Y, Rhys-Evans P, Harrington K, Nutting C, et al. Hyperfractionated Accelerated Radiotherapy (HART) for anaplastic thyroid carcinoma: toxicity and survival analysis. Int J Radiat Oncol Biol Phys. 2009;74(2):518–21.

    Article  PubMed  Google Scholar 

  31. De Crevoisier R, Baudin E, Bachelot A, Leboulleux S, Travagli JP, Caillou B, et al. Combined treatment of anaplastic thyroid carcinoma with surgery, chemotherapy, and hyperfractionated accelerated external radiotherapy. Int J Radiat Oncol Biol Phys. 2004;60(4):1137–43.

    Article  PubMed  Google Scholar 

  32. Wong CS, Van Dyk J, Simpson WJ. Myelopathy following hyperfractionated accelerated radiotherapy for anaplastic thyroid carcinoma. Radiother Oncol. 1991;20(1):3–9.

    Article  CAS  PubMed  Google Scholar 

  33. Tennvall J, Lundell G, Wahlberg P, Bergenfelz A, Grimelius L, Akerman M, et al. Anaplastic thyroid carcinoma: three protocols combining doxorubicin, hyperfractionated radiotherapy and surgery. Br J Cancer. 2002;86(12):1848–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Pudney D, Lau H, Ruether JD, Falck V. Clinical experience of the multimodality management of anaplastic thyroid cancer and literature review. Thyroid. 2007;17(12):1243–50.

    Article  PubMed  Google Scholar 

  35. Besic N, Auersperg M, Us-Krasovec M, Golouh R, Frkovic-Grazio S, Vodnik A. Effect of primary treatment on survival in anaplastic thyroid carcinoma. Eur J Surg Oncol. 2001;27(3):260–4.

    Article  CAS  PubMed  Google Scholar 

  36. Sugino K, Ito K, Mimura T, Nagahama M, Fukunari N, Kubo A, et al. The important role of operations in the management of anaplastic thyroid carcinoma. Surgery. 2002;131(3):245–8.

    Article  PubMed  Google Scholar 

  37. Heron DE, Karimpour S, Grigsby PW. Anaplastic thyroid carcinoma: comparison of conventional radiotherapy and hyperfractionation chemoradiotherapy in two groups. Am J Clin Oncol. 2002;25(5):442–6.

    Article  PubMed  Google Scholar 

  38. Troch M, Koperek O, Scheuba C, Dieckmann K, Hoffmann M, Niederle B, et al. High efficacy of concomitant treatment of undifferentiated (anaplastic) thyroid cancer with radiation and docetaxel. J Clin Endocrinol Metab. 2010;95(9):E54–7.

    Article  PubMed  Google Scholar 

  39. Nehs MA, Nagarkatti S, Nucera C, Hodin RA, Parangi S. Thyroidectomy with neoadjuvant PLX4720 extends survival and decreases tumor burden in an orthotopic mouse model of anaplastic thyroid cancer. Surgery. 2010;148(6):1154–62. discussion 62.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Seto A, Sugitani I, Toda K, Kawabata K, Takahashi S, Saotome T. Chemotherapy for anaplastic thyroid cancer using docetaxel and cisplatin: report of eight cases. Surg Today. 2015;45(2):221–6.

    Article  CAS  PubMed  Google Scholar 

  41. Guerra A, Di Crescenzo V, Garzi A, Cinelli M, Carlomagno C, Tonacchera M, et al. Genetic mutations in the treatment of anaplastic thyroid cancer: a systematic review. BMC Surg. 2013;13(Suppl 2):S44.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Smallridge RC, Marlow LA, Copland JA. Anaplastic thyroid cancer: molecular pathogenesis and emerging therapies. Endocr Relat Cancer. 2009;16(1):17–44.

    Article  CAS  PubMed  Google Scholar 

  43. Ragazzi M, Ciarrocchi A, Sancisi V, Gandolfi G, Bisagni A, Piana S. Update on anaplastic thyroid carcinoma: morphological, molecular, and genetic features of the most aggressive thyroid cancer. Int J Endocrinol. 2014;2014:790834.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Pinto N, Black M, Patel K, Yoo J, Mymryk JS, Barrett JW, et al. Genomically driven precision medicine to improve outcomes in anaplastic thyroid cancer. J Oncol. 2014;2014:936285.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Nehs MA, Nucera C, Nagarkatti SS, Sadow PM, Morales-Garcia D, Hodin RA, et al. Late intervention with anti-BRAF(V600E) therapy induces tumor regression in an orthotopic mouse model of human anaplastic thyroid cancer. Endocrinology. 2012;153(2):985–94.

    Article  CAS  PubMed  Google Scholar 

  46. Ha HT, Lee JS, Urba S, Koenig RJ, Sisson J, Giordano T, et al. A phase II study of imatinib in patients with advanced anaplastic thyroid cancer. Thyroid. 2010;20(9):975–80.

    Article  CAS  PubMed  Google Scholar 

  47. Bible KC, Suman VJ, Menefee ME, Smallridge RC, Molina JR, Maples WJ, et al. A multiinstitutional phase 2 trial of pazopanib monotherapy in advanced anaplastic thyroid cancer. J Clin Endocrinol Metab. 2012;97(9):3179–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Lim SM, Chang H, Yoon MJ, Hong YK, Kim H, Chung WY, et al. A multicenter, phase II trial of everolimus in locally advanced or metastatic thyroid cancer of all histologic subtypes. Ann Oncol. 2013;24(12):3089–94.

    Article  CAS  PubMed  Google Scholar 

  49. Smallridge RC, Copland JA, Brose MS, Wadsworth JT, Houvras Y, Menefee ME, et al. Efatutazone, an oral PPAR-gamma agonist, in combination with paclitaxel in anaplastic thyroid cancer: results of a multicenter phase 1 trial. J Clin Endocrinol Metab. 2013;98(6):2392–400.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Sosa JA, Elisei R, Jarzab B, Balkissoon J, Lu SP, Bal C, et al. Randomized safety and efficacy study of fosbretabulin with paclitaxel/carboplatin against anaplastic thyroid carcinoma. Thyroid. 2014;24(2):232–40.

    Article  CAS  PubMed  Google Scholar 

  51. Mooney CJ, Nagaiah G, Fu P, Wasman JK, Cooney MM, Savvides PS, et al. A phase II trial of fosbretabulin in advanced anaplastic thyroid carcinoma and correlation of baseline serum-soluble intracellular adhesion molecule-1 with outcome. Thyroid. 2009;19(3):233–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Isham CR, Bossou AR, Negron V, Fisher KE, Kumar R, Marlow L, et al. Pazopanib enhances paclitaxel-induced mitotic catastrophe in anaplastic thyroid cancer. Sci Transl Med. 2013;5(166):166ra3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. John H. Stroger, Jr. Hospital of Cook County, Department of Surgery, Chicago, IL, USA

    Shabirhusain Abadin & Subhash Patel

  2. NorthShore University HealthSystem/John H. Stroger Hospital of Cook County, Department of Surgery, Evanston, IL, USA

    Paritosh Suman

  3. John H. Stroger, Jr. Hospital of Cook County, Department of Endocrinology and Diabetes, Chicago, IL, USA

    Jessica Hwang

  4. Department of Radiation Oncology, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA

    Anu Thakrar

Authors
  1. Shabirhusain Abadin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paritosh Suman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jessica Hwang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anu Thakrar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Subhash Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shabirhusain Abadin .

Editor information

Editors and Affiliations

  1. Department of Surgery and MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL, USA

    Peter Angelos

  2. Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA

    Raymon H. Grogan

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Abadin, S., Suman, P., Hwang, J., Thakrar, A., Patel, S. (2018). First-Line Therapy for Anaplastic Thyroid Cancer: Operation Versus Medical Management. In: Angelos, P., Grogan, R. (eds) Difficult Decisions in Endocrine Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-319-92860-9_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-92860-9_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-92858-6

  • Online ISBN: 978-3-319-92860-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation