Service d'endocrinologie, diabétologie, maladies métaboliques, faculté de médecine, Clermont-Ferrand, France.
Ann Endocrinol (Paris). 2010 Feb;71(1):38-45. doi: 10.1016/j.ando.2009.10.013. Epub 2009 Dec 2.
The aim of this study is to retrospectively describe the epidemiological and clinical features, therapeutic modalities, prognostic factors and survival figures in a population of patients with anaplastic thyroid carcinoma (ATC) observed in Auvergne, France. We compared these data with those in the literature.
The analysis was conducted based on a computer database containing a regional register recorded by health professionals treating ATC.
Of the 1500 cancers observed over 16 years, 26 were identified as ATC. The male/female ratio was 1/2.7 and the average age: 72.1; 76.9% of the cases had thyroid medical history, average tumor size at diagnosis was 7.35 cm with N1 in the course of illness in 61.5% of cases, M1 in 34.6% of cases. Surgery was performed in 84.6% of cases, radiotherapy in 53.8% and chemotherapy in 19.2%. The average survival was 9 months, the survival median: 4 months.
Our results show that, in univariate analysis, age above 75, capsular invasion, lymph nodes metastasis, tumor residue after surgery and lack of multimodal treatment (particularly radiotherapy in patients without tumor residue) are factors of poor prognosis. In a multivariate analysis only age above 75, followed by node invasion, capsular invasion, and finally female gender are factors of poor prognosis.
本研究旨在回顾性描述法国奥弗涅地区一组间变性甲状腺癌（ATC）患者的流行病学和临床特征、治疗方式、预后因素和生存数据，并与文献中的数据进行比较。
该分析基于一个由治疗 ATC 的卫生专业人员记录的区域性登记处的计算机数据库进行。
在 16 年期间观察到的 1500 例癌症中，有 26 例被确定为 ATC。男女比例为 1/2.7，平均年龄为 72.1 岁；76.9%的病例有甲状腺病史，平均诊断时肿瘤大小为 7.35cm，病程中 N1 占 61.5%，M1 占 34.6%。84.6%的病例进行了手术，53.8%的病例接受了放疗，19.2%的病例接受了化疗。平均生存时间为 9 个月，生存中位数为 4 个月。
我们的结果表明，在单因素分析中，年龄大于 75 岁、包膜侵犯、淋巴结转移、手术后肿瘤残留以及缺乏多模式治疗（特别是对于无肿瘤残留的患者）是预后不良的因素。在多因素分析中，仅年龄大于 75 岁、其次是淋巴结侵犯、包膜侵犯，最后是女性是预后不良的因素。
