Prognosis of Anaplastic Thyroid Cancer

  • ATC has a rapidly progressive course and early dissemination
  • The most common sites of distant spread include, in descending order:
    • The lung, bone, and brain
  • Metastases, particularly in the lung:
    • Are likely to be present at diagnosis in more than 50% of cases
  • The overall 5-year survival rate:
    • Is reportedly less than 10%, and most patients do not live longer than a few months after diagnosis
  • One study has shown that patients younger than 60 years who have ATC confined to the thyroid:
    • Have a better prognosis than patients who are older and have distant metastases
  • A retrospective study from Korea found that:
    • Age less than 60 years, tumor size less than 7 cm, and lesser extent of disease:
      • Were independent predictors of lower disease-specific mortality 
  • While some studies have suggested that postoperative radiotherapy:
    • May be of benefit in terms of survival, definitive prospective trials are lacking
  • Akaishi et al conducted a review of 100 patients with ATC in a single hospital (Ito Hospital) from 1993-2009:
    • The 1-year survival rates were as follows:
      • Stage IVA – 72.7%
      • Stable IVB- 24.8%
      • Stable IVC – 8.2%
  • Multivariate analysis demonstrated worse prognosis with:
    • Age older than 70 years, white blood cell count of 10,000/μL or more, extrathyroidal invasion, and distant metastases at the time of diagnosis
  • Survival was significantly better if the patient received complete resection, external radiation at doses of 40 Gy or more, or both
  • Orita et al developed a prognostic index that can predict prognosis and assist in the early treatment of ATC

#Arrangoiz #ThyroidSurgeon #CancerSurgeon #SurgicalOncologist #HeadandNeckSurgeon #EndocrineSurgery #ThyroidCancer #Miami #Mexico #MountSinaiMedicalCenter #Surgeon #Teacher #ThyroidNodules #RadioactiveIodine #RAI #PTC #MSMC

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