Department of Endocrine Surgery, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, UK,
World J Surg. 2013 Nov;37(11):2589-93. doi: 10.1007/s00268-013-2173-8.
Anaplastic thyroid carcinoma (ATC) is the most aggressive form of thyroid cancer and it has an extremely poor prognosis. Rapid airway compromise is the main cause of death in patients with ATC.
The present study is based on a retrospective review of clinical data of patients with ATC treated over the last decade in a tertiary referral center.
Between January 1998 and December 2010, 31 patients (13 males: 18 females) with a mean age of 74 years (range: 54-90 years) had a diagnosis of ATC made on fine-needle aspiration (n = 29) or biopsy (n = 2). Eight patients underwent total thyroidectomy and lymph node dissection, and five patients had attempted surgery but the procedure was abandoned because of inoperability. Airway compromise was clinically apparent in 11 patients. Five patients had tracheal stents inserted, with a median survival of 2 months (range: 1-36 months). In the whole cohort, 29 patients died of the disease, with a mean survival of 7 months (range: 1-36 months).
Survival of patients with undifferentiated thyroid cancer is severely compromised by airway obstruction. Palliation with tracheal stenting can rescue catastrophic airway obstruction but offers minimal survival benefit.
间变性甲状腺癌（ATC）是甲状腺癌中最具侵袭性的形式，其预后极差。快速气道阻塞是 ATC 患者死亡的主要原因。
本研究基于过去十年在一家三级转诊中心接受治疗的 ATC 患者的临床数据回顾。
1998 年 1 月至 2010 年 12 月期间，31 例患者（男性 13 例，女性 18 例）平均年龄为 74 岁（范围：54-90 岁），经细针抽吸（n=29）或活检（n=2）诊断为 ATC。8 例患者接受了全甲状腺切除术和淋巴结清扫术，5 例患者试图手术，但由于无法手术而放弃。11 例患者出现气道阻塞的临床表现。5 例患者插入气管支架，中位生存时间为 2 个月（范围：1-36 个月）。在整个队列中，29 例患者死于该疾病，平均生存时间为 7 个月（范围：1-36 个月）。
未分化甲状腺癌患者的生存因气道阻塞而严重受损。气管支架置入术可缓解灾难性气道阻塞，但生存获益最小。
