CLINICAL EVALUATION OF TREATMENT FOR ANAPLASTIC CARCINOMA OF THE THYROID

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 59; no. 1; pp. 1 - 5
• Main Authors: HAMA, Yoshihisa, AMANO, Jun, YOKOYAMA, Shiro, SHINGU, Kiyoshi, ITO, Ken-ichi, FUJIMORI, Minoru, KOBAYASHI, Shinya, KASUGA, Yoshio
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 1998
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.59.1

In our therapeutic guidelines for anaplastic carcinoma of the thyroid, we first conduct either excision of the tumor (surgery) or open biopsy with radiation as local control to avoid asphyxy due to the increasing tumor, followed by chemotherapy. This study was designed to compare the therapeutic results retrospectively between the surgery group and open biopsy with radiation group. Subjects were 21 (3.1%) evaluable patients with anaplastic carcinoma from a series of 668 cases of primary thyroid carcinoma treated at the hospital in a recent 16-years from January 1980 to December 1995. Of these 21 cases, 10 cases underwent surgery (Group S) and 11 cases open biopsy with radiation (Group B). There was no significant difference between Group S and Group B in clinical factors such as age, tumor size, tumor extent, distant metastases, and treatments except for surgery. One year survival rate was 10.0% in Group S and 27.3% in Group B. Although there was no significant difference in the survival rate, Group B outnumbered Group S4 to 2 in long survival patients who survived more than one year. Moreover, though no significant difference was noted in local recurrence, a better influence on the patients' quality of life in Group B was evident. Therefore, the most effective strategy for anaplastic carcinoma of the thyroid at present is to perform open biopsy with radiotherapy followed by chemotherapy as soon as possible after diagnosis. Surgery should be permitted in only operable cases without resecting the surrounding organs.