ARTICOLI ORIGINALI   

Minerva Chirurgica 2014 October;69(5):261-9

Copyright © 2014 EDIZIONI MINERVA MEDICA

lingua: Inglese

Thyroid anaplastic carcinoma: the impact of multimodality treatment on survival. The experience of a referral center for endocrine surgery

Polistena A., Monacelli M., Lucchini R., Triola R., Conti C., Avenia S., Sole Di Patrizi M., Barillaro I., Boccolini A., Sanguinetti A., Avenia N. ✉

University of Perugia, Medical School, Endocrine Surgery Unit, S. Maria University Hospital Terni, Terni, Italy

AIM: Anaplastic thyroid carcinoma (ATC) is characterized by local invasiveness, risk of recurrence and very poor prognosis.
METHODS: We retrospectively reviewed 79 consecutive patients treated between 1996 and 2012. We analysed the multimodality treatment of ATC considering the impact of surgery and radiotherapy on survival.
RESULTS: Patients were divided in groups A and B (tumor less and larger than 5 cm). Surgery was carried out in 44 patients, radiotherapy in 48 patients. Tracheostomy and endoprosthesis were used respectively in 48.1% and in 25.3% of patients. The mean survival was 5.35 (±3.2) months with no significant difference in group A vs. group B. Considering patients undergone surgery, significant impact on survival was observed comparing A vs. B (P=0.013). Combination of surgery and radiotherapy significantly improves outcome comparing A vs. B (P=0.017). Improvement in survival compared to no treatment at all was observed in both groups respectively for surgery (P=0.001 and P=0.0001) and radiotherapy (P=0.047 and P=0.0001).
CONCLUSION: Although the severity of prognosis of ATC, multimodality treatment still significantly improves local control of the disease achieving acceptable survival in selected patients and adequate palliation of symptoms for the others. Surgery is still a fundamental treatment.