Kim, Seok-Mo1, Kim, Soo Young1, Kim, Bup-Woo1, Lee, Yong Sang1, Chang, Hang-Seok1, Park, Cheong Soo1
1 Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Introduction: Anaplastic cancer is one of the most aggressive and rapidly progressing malignant human neoplasms with a grave prognosis. The optimal management of this disease remains controversial especially for cancer at advanced stage with distant metastasis. In this study, we report the outcome of multi-modality treatment in 52 cases of ATCs over a 13-year period.
Material and Methods: From January 2003 to October 2016, 52 patients of ATC who were treated at our institution were enrolled in this study. These patient’s records were retrospectively analyzed with respect to clinical manifestations, extent of disease, distant metastasis, treatment modality and cause of death.
Results: 52 patients (33 female, 19 male, mean age 64.5 years) with histologically proven ATCs were enrolled. Most of the patients (59.6%) presented with a growing mass at the point of diagnosis, followed by Hoarseness (26.9%) and Pain (21.2%). Extrathyroidal extension (Stage T4b) was seen in 33 (63.5%) patients. In 32 patients, metastasis was observed with lung metastasis being the frequently seen (96.9%). As treatment modalities, surgery (33 patients 63.5%), chemotherapy (27, 51.9%), targeted therapy (16, 31.4%) and radiotherapy (32, 61.5%) was performed, whereas combination therapy was observed in 45 patients. In Kaplan-Meier analyses, multimodality treatment showed better survival than no treatment (p<0.005). Furthermore, multimodality treatment showed prolonged survival in T4b cancer and in cases with distant metastasis.
Conclusion: ATC is an aggressive cancer with advanced stage at time of presentation. Active multimodality treatment may be considered to prolong survival in T4b and M1 cases.