Limits...
Anaplastic Thyroid Cancer: Experience of the Philippine General Hospital.

Lo TE, Jimeno CA, Paz-Pacheco E - Endocrinol Metab (Seoul) (2014)

Bottom Line: An absence of distant metastases and lymph node involvement was associated with improved survival outcomes, whereas age at diagnosis and tumor size did not affect survival.Curative surgery offers the most effective means of prolonging survival.Radiotherapy and chemotherapy in combination with surgery represents a promising treatment strategy.

View Article: PubMed Central - PubMed

Affiliation: Section of Endocrinology and Metabolism, Department of Medicine, University of the Philippines-Philippine General Hospital, Manila, Philippine. tomedwardlo@yahoo.com.

ABSTRACT

Background: Anaplastic thyroid cancer (ATC) is a rare type of thyroid malignancy and one of the most aggressive solid tumors, responsible for between 14% and 50% of the total annual mortality associated with thyroid cancer.

Methods: A retrospective study was made of all ATC cases diagnosed by biopsy in the Philippine General Hospital between 2008 and 2013.

Results: A total of 15 patients were identified, with a median age at diagnosis of 63 years. All tumors were at least 6 cm in size upon diagnosis. All patients had a previous history of thyroid pathology, presenting with an average duration of 11 years. Eleven patients presented with cervical lymphadenopathies, whereas seven exhibited signs of distant metastases, for which the lungs appeared to be the most common site. More than 70% of the patients presented with a rapidly growing neck mass, leading to airway obstruction. Only three patients were treated using curative surgery; the majority received palliative and supportive forms of treatment. In addition, only three patients were offered radiotherapy. Chemotherapy was not offered to any patient. Only two patients were confirmed to still be alive during the study period. The median survival time for the other patients was 3 months; in the majority of cases the patient died within the first year following diagnosis.

Conclusion: Our experience with ATC demonstrated concordance with other institutions with respect to current clinical profile, presentation, and prognosis. An absence of distant metastases and lymph node involvement was associated with improved survival outcomes, whereas age at diagnosis and tumor size did not affect survival. Curative surgery offers the most effective means of prolonging survival. Radiotherapy and chemotherapy in combination with surgery represents a promising treatment strategy.

No MeSH data available.


Related in: MedlinePlus

Survival curve of Filipino patients with anaplastic thyroid cancer following diagnosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4508264&req=5

Figure 1: Survival curve of Filipino patients with anaplastic thyroid cancer following diagnosis.

Mentions: Only three patients (20%) were treated with curative intent via total thyroidectomy with or without radical neck dissection. The majority (80%) of patients received palliative and supportive forms of treatment because of massive metastases upon diagnosis and unresectability of the tumor. Five patients (33%) required an emergency tracheostomy to prevent significant tracheal compression. Only three patients (20%) were offered radiotherapy, but none were able to complete the full regimen. Chemotherapy was not offered to any patient. Only four patients (27%) were referred to hospices, for family meetings and end-of-life care. Only two patients were confirmed as still being alive during the study period (Table 1). The median survival time for the other patients was 3 months from the date of admission and diagnosis. The majority (>90%) of the patients died within the first year following diagnosis (Fig. 1).


Anaplastic Thyroid Cancer: Experience of the Philippine General Hospital.

Lo TE, Jimeno CA, Paz-Pacheco E - Endocrinol Metab (Seoul) (2014)

Survival curve of Filipino patients with anaplastic thyroid cancer following diagnosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508264&req=5

Figure 1: Survival curve of Filipino patients with anaplastic thyroid cancer following diagnosis.
Mentions: Only three patients (20%) were treated with curative intent via total thyroidectomy with or without radical neck dissection. The majority (80%) of patients received palliative and supportive forms of treatment because of massive metastases upon diagnosis and unresectability of the tumor. Five patients (33%) required an emergency tracheostomy to prevent significant tracheal compression. Only three patients (20%) were offered radiotherapy, but none were able to complete the full regimen. Chemotherapy was not offered to any patient. Only four patients (27%) were referred to hospices, for family meetings and end-of-life care. Only two patients were confirmed as still being alive during the study period (Table 1). The median survival time for the other patients was 3 months from the date of admission and diagnosis. The majority (>90%) of the patients died within the first year following diagnosis (Fig. 1).

Bottom Line: An absence of distant metastases and lymph node involvement was associated with improved survival outcomes, whereas age at diagnosis and tumor size did not affect survival.Curative surgery offers the most effective means of prolonging survival.Radiotherapy and chemotherapy in combination with surgery represents a promising treatment strategy.

View Article: PubMed Central - PubMed

Affiliation: Section of Endocrinology and Metabolism, Department of Medicine, University of the Philippines-Philippine General Hospital, Manila, Philippine. tomedwardlo@yahoo.com.

ABSTRACT

Background: Anaplastic thyroid cancer (ATC) is a rare type of thyroid malignancy and one of the most aggressive solid tumors, responsible for between 14% and 50% of the total annual mortality associated with thyroid cancer.

Methods: A retrospective study was made of all ATC cases diagnosed by biopsy in the Philippine General Hospital between 2008 and 2013.

Results: A total of 15 patients were identified, with a median age at diagnosis of 63 years. All tumors were at least 6 cm in size upon diagnosis. All patients had a previous history of thyroid pathology, presenting with an average duration of 11 years. Eleven patients presented with cervical lymphadenopathies, whereas seven exhibited signs of distant metastases, for which the lungs appeared to be the most common site. More than 70% of the patients presented with a rapidly growing neck mass, leading to airway obstruction. Only three patients were treated using curative surgery; the majority received palliative and supportive forms of treatment. In addition, only three patients were offered radiotherapy. Chemotherapy was not offered to any patient. Only two patients were confirmed to still be alive during the study period. The median survival time for the other patients was 3 months; in the majority of cases the patient died within the first year following diagnosis.

Conclusion: Our experience with ATC demonstrated concordance with other institutions with respect to current clinical profile, presentation, and prognosis. An absence of distant metastases and lymph node involvement was associated with improved survival outcomes, whereas age at diagnosis and tumor size did not affect survival. Curative surgery offers the most effective means of prolonging survival. Radiotherapy and chemotherapy in combination with surgery represents a promising treatment strategy.

No MeSH data available.


Related in: MedlinePlus