Jannin Arnaud, Escande Alexandre, Al Ghuzlan Abir, Blanchard Pierre, Hartl Dana, Chevalier Benjamin, Deschamps Frédéric, Lamartina Livia, Lacroix Ludovic, Dupuy Corinne, Baudin Eric, Do Cao Christine, Hadoux Julien
Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille University Hospital, 59000 Lille, France.
H. Warembourg School of Medicine, University of Lille, 59000 Lille, France.
Cancers (Basel). 2022 Feb 19;14(4):1061. doi: 10.3390/cancers14041061.
Anaplastic thyroid carcinoma (ATC) is a rare and undifferentiated form of thyroid cancer. Its prognosis is poor: the median overall survival (OS) of patients varies from 4 to 10 months after diagnosis. However, a doubling of the OS time may be possible owing to a more systematic use of molecular tests for targeted therapies and integration of fast-track dedicated care pathways for these patients in tertiary centers. The diagnostic confirmation, if needed, requires an urgent biopsy reread by an expert pathologist with additional immunohistochemical and molecular analyses. Therapeutic management, defined in multidisciplinary meetings, respecting the patient's choice, must start within days following diagnosis. For localized disease diagnosed after primary surgical treatment, adjuvant chemo-radiotherapy is recommended. In the event of locally advanced or metastatic disease, the prognosis is very poor. Treatment should then involve chemotherapy or targeted therapy and decompressive cervical radiotherapy. Here we will review current knowledge on ATC and provide perspectives to improve the management of this deadly disease.
间变性甲状腺癌(ATC)是一种罕见的未分化型甲状腺癌。其预后很差:患者确诊后的中位总生存期(OS)为4至10个月。然而,由于更系统地使用分子检测进行靶向治疗,以及在三级中心为这些患者整合快速通道专用护理路径,总生存期翻倍或许是有可能的。如有必要,诊断确认需要由专家病理学家紧急重新阅片,并进行额外的免疫组织化学和分子分析。多学科会议确定的治疗管理,要尊重患者的选择,必须在诊断后的数天内开始。对于初次手术治疗后诊断为局限性疾病的患者,建议进行辅助放化疗。如果是局部晚期或转移性疾病,预后非常差。此时的治疗应包括化疗或靶向治疗以及减压性颈部放疗。在此,我们将回顾关于间变性甲状腺癌的现有知识,并提供改善这种致命疾病管理的观点。