Kanai Toshiharu, Ito Tokiko, Morikawa Hiroki, Amitani Masatsugu, Shimizu Tadafumi, Ohno Koichi, Ono Mayu, Oba Takaaki, Maeno Kazuma, Ito Ken-Ichi
Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-861, Japan.
Surg Today. 2022 Nov;52(11):1620-1626. doi: 10.1007/s00595-022-02494-8. Epub 2022 Apr 17.
Anaplastic thyroid cancer (ATC) is a highly aggressive tumor that invades surrounding tissues and rapidly metastasizes throughout the body. Growth of the primary tumor in the neck often causes serious conditions that decrease the quality of life (QOL) of patients. The objective of this study was to investigate the role of surgical resection in improving the QOL of patients with ATC.
This was a retrospective review of 62 patients with ATC treated at Shinshu University Hospital between January 2001 and June 2019.
Fourteen patients underwent R0/R1 resection. Thirteen of the 14 patients received postoperative radiation, and 4 received chemotherapy. The mean survival period was 15.4 ± 18.2 (range, 2-75) months. Distant metastases appeared within 3.2 ± 2.3 months postoperatively in 12 patients. A permanent tracheostomy was required in six patients; however, eight patients did not show airway obstruction until death. Daily treatment for exudate or bleeding from tumors that eroded in the neck, which deteriorated the QOL, was unnecessary in 12 patients.
As surgical resection can improve the QOL in patients with ATC, thyroid surgeons should promptly and carefully evaluate the resectability of the tumor and favor resection as much as possible.
间变性甲状腺癌（ATC）是一种侵袭性很强的肿瘤，可侵犯周围组织并迅速发生全身转移。颈部原发性肿瘤的生长常导致严重情况，降低患者的生活质量（QOL）。本研究的目的是探讨手术切除在改善ATC患者生活质量中的作用。
这是一项对2001年1月至2019年6月在信州大学医院接受治疗的62例ATC患者的回顾性研究。
14例患者接受了R0/R1切除。14例患者中有13例接受了术后放疗，4例接受了化疗。平均生存期为15.4±18.2（范围2 - 75）个月。12例患者术后3.2±2.3个月内出现远处转移。6例患者需要永久性气管造口术；然而，8例患者直至死亡均未出现气道阻塞。12例患者无需对颈部肿瘤侵蚀引起的渗出或出血进行日常治疗，这些情况会使生活质量恶化。
由于手术切除可改善ATC患者的生活质量，甲状腺外科医生应迅速且仔细地评估肿瘤的可切除性，并尽可能倾向于进行切除。
