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Anaplastic thyroid cancer yields low remission, high recurrence rate after surgery
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Patients with aggressive thyroid cancer pathology with tracheal and lymphovascular invasion need careful monitoring for the development of distant metastasis, according to findings published in Thyroid.
Compared with patients with anaplastic thyroid cancer (ATC), remission of resectable tumors was higher and the recurrence rate was lower in patients with differentiated thyroid cancer (DTC) with anaplastic foci and poorly differentiated thyroid cancer (PDTC), according to the researchers.
J. Hun Hah, MD, PhD, of the department of otorhinolaryngology-head and neck surgery, and Young Joo Park, MD, PhD, of the department of internal medicine at Seoul National University Hospital, and colleagues evaluated 199 patients with ATC and PDTC who underwent surgery with curative intent between 1985 and 2013. Clinical response to treatment and the recurrence rates of three separate thyroid cancer groups (ATC, DTC with anaplastic foci and PDTC) were the main outcome measures. Researchers aimed to determine the recurrence and survival rate of cancer after surgery.
Eighty-four percent of participants reached initial remission, which was highest in DTC with anaplastic foci (97.8%), followed by PDTC (96.7%) and ATC (60.5%; P < .001). Fifteen percent of participants who achieved initial remission experienced a recurrence, which was highest in ATC (30.8%) and lowest in DTC with anaplastic foci (6.7%; P < .001). Sixteen patients who experienced a recurrence died from the disease; 14 were due to distant metastasis, and two were due to locoregional failure.
Overall mortality after surgery was highest in participants with ATC (58.1%), followed by PDTC (20%) and DTC with anaplastic foci (8.7%).
“Age was significantly correlated with initial remission, and tracheal invasion and lymphovascular invasion were correlated with recurrence,” the researchers wrote. “More aggressive treatment and careful follow-up may be necessary for tumors with aggressive pathology, tracheal invasion and lymphovascular invasion.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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