Department of Molecular Medicine and Surgery, Section of Endocrine Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
J Surg Oncol. 2012 Dec;106(8):981-6. doi: 10.1002/jso.23177. Epub 2012 Jun 4.
Anaplastic thyroid carcinoma (ATC) is a highly aggressive malignancy of the thyroid gland. Patients at our institution are treated with external radiotherapy up to 46 Gray (Gy) and low-dose doxorubicin prior to surgery. We retrospectively evaluated the outcome of ATC patients over a 13-year period.
Clinical, histopathological, and follow-up data for 59 patients diagnosed between 1997 and 2010 were collected and analyzed.
Median age at diagnosis was 77 years. Female-male ratio was 2.5:1. Median survival from time of diagnosis was 3.3 months. Thirty-six patients completed the treatment protocol (including surgery), of whom one succumbed due to local tumor growth. In multivariate analysis, the only factor significantly associated with longer survival among operated patients was absence of metastases at diagnosis (P = 0.031). No impact on survival time was found for gender, extent of surgical resection, and absence of extrathyroidal invasion.
Despite aggressive treatment, survival rates in ATC patients remain low. Locoregional control is feasible for most patients, underscoring the importance of an intense, multimodal treatment regimen. Further oncological intervention is of crucial importance to achieve a better prognosis for ATC patients.
间变性甲状腺癌（ATC）是甲状腺的一种高度侵袭性恶性肿瘤。在我们的机构中，患者在手术前接受高达 46 戈瑞（Gy）的外部放射治疗和低剂量阿霉素治疗。我们回顾性评估了 13 年来 ATC 患者的结果。
收集并分析了 1997 年至 2010 年间诊断的 59 例患者的临床、组织病理学和随访数据。
诊断时的中位年龄为 77 岁。女性与男性的比例为 2.5:1。从诊断时间到中位数的生存时间为 3.3 个月。36 例患者完成了治疗方案（包括手术），其中 1 例因局部肿瘤生长而死亡。在多变量分析中，手术患者中唯一与更长生存时间显著相关的因素是诊断时无转移（P=0.031）。性别、手术切除范围和无甲状腺外侵犯对生存时间均无影响。
尽管采用了积极的治疗方法，ATC 患者的生存率仍然较低。大多数患者的局部区域控制是可行的，这强调了强化、多模式治疗方案的重要性。进一步的肿瘤学干预对于改善 ATC 患者的预后至关重要。
