Sen Masaomi, Ito Ryo, Abe Takeshi, Kazusaka Hiroko, Matsui Mami, Saitou Marie, Nagaoka Ryuta, Jikuzono Tomoo, Sugitani Iwao
Department of Endocrine Surgery, Nippon Medical Musashi Kosugi Hospital, 1-383 Kosugi-cho, Nakahara-ku, Kawasaki-shi, Kanagawa, 211-8533, Japan.
Department of Endocrine Surgery, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
Surg Today. 2025 Jan 6. doi: 10.1007/s00595-024-02991-y.
Tumor/node/metastasis staging and prognostic index (PI) are used to predict prognosis and guide treatment for anaplastic thyroid carcinoma (ATC). With the advent of treatments, such as BRAF/MEK inhibitors and immune checkpoint inhibitors, dynamic markers to assess disease status and treatment efficacy are needed. This study examined the utility of PI as a dynamic marker for ATC treatment.
This retrospective study investigated 20 patients with ATC who were treated aggressively from January 2011 to December 2022. Patients were categorized into low-, high-, low-, and high-high groups according to the PI before and after treatment. Survival was then compared between the groups.
The median overall survival was not reached for the Low-Low, 363 days for the High-Low, 158.5 days for the Low-High, and 90.5 days for the High-High groups (p < 0.01). Among the 13 patients with an initially high PI, 6 patients achieved a low PI during treatment, but three showed subsequent increases. Categorizing PI further into decreased, temporarily decreased, and non-decreased groups, median overall survival was 363 days, 158.5 days, and 87 days, respectively (p < 0.01).
PI is a critical prognostic indicator that facilitates treatment decision-making for ATC. PI may also have potential as a dynamic marker for assessing the disease status and treatment efficacy.
肿瘤/淋巴结/转移分期及预后指数（PI）用于预测间变性甲状腺癌（ATC）的预后并指导治疗。随着BRAF/MEK抑制剂和免疫检查点抑制剂等治疗方法的出现，需要动态标志物来评估疾病状态和治疗效果。本研究探讨了PI作为ATC治疗动态标志物的效用。
这项回顾性研究调查了2011年1月至2022年12月期间接受积极治疗的20例ATC患者。根据治疗前后的PI将患者分为低-低、高-低、低-高和高-高组。然后比较各组之间的生存率。
低-低组的中位总生存期未达到，高-低组为363天，低-高组为158.5天，高-高组为90.5天（p<0.01）。在最初PI较高的13例患者中，6例在治疗期间PI降至低水平，但3例随后又升高。将PI进一步分为降低、暂时降低和未降低组，中位总生存期分别为363天、158.5天和87天（p<0.01）。
PI是一个关键的预后指标，有助于ATC的治疗决策。PI也可能有潜力作为评估疾病状态和治疗效果的动态标志物。
