Survival Benefit of Intervention Treatment in Advanced Anaplastic Thyroid Cancer.

IF 1.6 Q4 ONCOLOGY
International Journal of Surgical Oncology Pub Date : 2021-06-03 eCollection Date: 2021-01-01 DOI:10.1155/2021/5545127
Pornthep Kasemsiri, Pimpika Chaisakgreenon, Patravoot Vatanasapt, Supawan Laohasiriwong, Watchareeporn Teeramatwanich, Cattleya Thongrong, Teeraporn Ratanaanekchai, Surapol Suetrong
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引用次数: 2

Abstract

Background: The management of anaplastic thyroid cancer (ATC) is controversial; thus, proper treatment and prognostic factors should be investigated.

Objectives: To compare the survival outcomes of the intervention and palliative treatment in ATC patients.

Methods: A hospital-based retrospective study was conducted at a single tertiary university hospital. The medical record charts were retrieved from November 20, 1987, to December 31, 2016. The final follow-up ended by December 31, 2017. The patients' demographic data, laboratory data, clinical presentation, and treatment modality results were analyzed.

Results: One hundred twenty-one records were analyzed with a one-year overall survival rate of 3.5% (median survival time: 77 days); however, 16 cases had insufficient data to classify staging and treatment modalities. Therefore, 105 ATC patients (37 with stage IVa, 39 with stage IVb, and 29 with stage IVc disease) were included with a one-year overall survival rate of 4.0% (median survival time of 82 days). Intervention treatment allowed longer median survival times (p < 0.05) and a better survival rate (p < 0.05). Among the interventional treatment groups, postoperative chemoradiation yielded the longest median survival time (187 days) and the highest survival rate (20%) (p < 0.05). The intervention modality allowed a better median survival time at all stages, particularly in stage IVa (p < 0.05). Unfavorable prognostic factors were adjusted for in a multiple Cox regression model showing that significant factors included age ≥65 years (hazard ratio HR: 2.57), palliative treatment (HR: 1.85), and leukocytosis ≥10,000 cells/mm3 (HR: 2.76).

Conclusions: Intervention treatment provided a better survival outcome in all stages, particularly in stage IVa, with a significantly better median survival time. Among interventional treatments, postoperative chemoradiation led to the longest survival rate, suggesting that this treatment should be considered in ATC patients with resectable tumors and no poor prognostic factors, such as older age and leukocytosis.

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晚期间变性甲状腺癌介入治疗的生存获益。
背景:间变性甲状腺癌(ATC)的治疗存在争议;因此,应研究适当的治疗和预后因素。目的:比较干预与姑息治疗对ATC患者的生存结局。方法:在一所三级大学医院进行回顾性研究。病历图检索时间为1987年11月20日至2016年12月31日。最后的随访于2017年12月31日结束。分析患者的人口学资料、实验室资料、临床表现和治疗方式结果。结果:121例患者1年总生存率为3.5%(中位生存时间为77天);然而,16例病例没有足够的数据来划分分期和治疗方式。因此,纳入105例ATC患者(IVa期37例,IVb期39例,IVc期29例),一年总生存率为4.0%(中位生存时间为82天)。干预治疗中位生存期延长(p < 0.05),生存率提高(p < 0.05)。在介入治疗组中,术后放化疗的中位生存时间最长(187天),生存率最高(20%)(p < 0.05)。干预方式在所有阶段的中位生存时间更长,特别是在IVa阶段(p < 0.05)。在多重Cox回归模型中调整了不利的预后因素,结果显示显著因素包括年龄≥65岁(危险比HR: 2.57)、姑息治疗(危险比HR: 1.85)和白细胞数量≥10,000个细胞/mm3(危险比HR: 2.76)。结论:干预治疗在所有阶段提供了更好的生存结果,特别是在IVa阶段,中位生存时间显着提高。在介入治疗中,术后放化疗生存率最长,提示对于可切除肿瘤且无高龄、白细胞增多等不良预后因素的ATC患者,应考虑采用放化疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
5
审稿时长
20 weeks
期刊介绍: International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.
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