Treatment and prognosis of anaplastic thyroid carcinoma: experience from a single institution in China

PLoS One. 2013 Nov 5;8(11):e80011. doi: 10.1371/journal.pone.0080011. eCollection 2013.

Abstract

Background: Anaplastic thyroid carcinoma (ATC), a highly aggressive malignancy, has a poor prognosis, and the consensus on the most effective treatment is needed.

Methods: Clinical data from all ATC patients treated in our institution over a 30-year period (between May 1980 and May 2010) were analyzed retrospectively with regard to mortality and survival rates (Kaplan-Meier). Multivariate analysis was performed using a Cox proportional hazards model.

Results: Sixty cases were analyzed. The overall 1- and 3-year survival rates were 35.0% and 22.9%, respectively. Univariate analysis showed that the best prognosis was seen in patients younger than 55 years, those without distant metastases, those with white blood cell (WBC) counts < 10.0 × 10(9)/L or blood platelet (PLT) counts < 300.0 × 10(9)/L at presentation, those who did not receive chemotherapy, and those who received radiotherapy doses ≥ 40 Gy or underwent surgery plus postoperative radiotherapy. According to multivariate analysis, the WBC count at first presentation and the type of therapeutic regimen independently influenced survival.

Conclusions: We found that the elevated peripheral PLT count may be an adverse prognostic factor of ATC patients. The prognosis for ATC is especially poor for patients with distant metastasis, a WBC count ≥ 10.0×10(9)/L, a PLT count ≥ 300.0 × 10(9)/L, or age ≥ 55 years. WBC count at presentation and surgery with or without postoperative radiotherapy independently influenced the prognosis. Intensive treatment combining surgery with postoperative radiotherapy is recommended for ATC patients with stage IVA/B disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma / drug therapy
  • Carcinoma / mortality
  • Carcinoma / pathology*
  • Carcinoma / radiotherapy
  • Female
  • Humans
  • Immunohistochemistry
  • Interleukin-11 / metabolism
  • Interleukin-6 / metabolism
  • Male
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Thyroid Carcinoma, Anaplastic
  • Thyroid Neoplasms / drug therapy
  • Thyroid Neoplasms / mortality
  • Thyroid Neoplasms / pathology*
  • Thyroid Neoplasms / radiotherapy

Substances

  • Interleukin-11
  • Interleukin-6

Grant support

This work was supported by grants from the National Natural Science Foundation of China (Numbers: 30960444, 81260402 and 81272955), Special Foundation of High Levels of Health Technical Personnel Training in Yunnan Province (No. D-201243), Natural Science Foundation of Guangdong Province, China (Numbers: 9451008901002400 and S2011010003997), and Science and Technology Planning Project of Guangdong Province, China (Number: 2012B031800089). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.