Oh Eun Mee, Lee Kyu Eun, Kwon Hyungju, Kim Eun Young, Bae Dong Sik, Youn Yeo-Kyu
Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea.
J Korean Surg Soc. 2012 Sep;83(3):123-9. doi: 10.4174/jkss.2012.83.3.123. Epub 2012 Aug 27.
Anaplastic thyroid cancer (ATC) is rare and has a poor prognosis. The aim of this study was to analyze the clinicopathologic characteristics of patients diagnosed with ATC expected to undergo curative thyroidectomy, with the goal of finding differences between patients surviving ≥6 months and <6 months.
From 1981 to 2010, 24 patients underwent thyroidectomy due to ATC. Among those patients, 12 suspected of distant metastasis preoperatively were excluded. The remaining 12 patients were analyzed by retrospective review of electronic medical records.
Median age was 55 years, and the male to female ratio was 1:5. All patients presented with neck mass at initial diagnosis. Five patients lived <6 months and seven patients lived ≥6 months after operation. In patients surviving ≥6 months, all lesions were <5 cm and all patients underwent total thyroidectomy. In patients surviving <6 months, two of the four lesions were >5 cm, and two of the five patients underwent less than total thyroidectomy (P = 0.287 and 0.152, respectively). All patients with lesion size <5 cm underwent total thyroidectomy and showed a shorter median operation time (P = 0.182 and 0.033, respectively).
ATC showed female predominance. Patients initially presented with neck mass, and median age was 55 years. In patients with ATC who are expected to undergo curative thyroidectomy, surgery should actively be considered as primary therapy for patient survival when the size is <5 cm.
间变性甲状腺癌(ATC)罕见且预后较差。本研究旨在分析预期接受根治性甲状腺切除术的ATC患者的临床病理特征,以找出存活≥6个月和<6个月的患者之间的差异。
1981年至2010年,24例因ATC接受甲状腺切除术的患者。其中,12例术前怀疑有远处转移的患者被排除。其余12例患者通过回顾电子病历进行分析。
中位年龄为55岁,男女比例为1:5。所有患者初诊时均有颈部肿块。5例患者术后存活<6个月,7例患者术后存活≥6个月。在存活≥6个月的患者中,所有病灶均<5 cm,所有患者均接受了全甲状腺切除术。在存活<6个月的患者中,4个病灶中有2个>5 cm,5例患者中有2例接受的甲状腺切除术少于全切除术(P分别为0.287和0.152)。所有病灶大小<5 cm的患者均接受了全甲状腺切除术,且中位手术时间较短(P分别为0.182和0.033)。
ATC以女性为主。患者初诊时表现为颈部肿块,中位年龄为55岁。对于预期接受根治性甲状腺切除术的ATC患者,当病灶大小<5 cm时,应积极考虑手术作为提高患者生存率的主要治疗方法。