Abstract
Background
Anaplastic thyroid carcinoma (ATC) is the most aggressive form of thyroid cancer and it has an extremely poor prognosis. Rapid airway compromise is the main cause of death in patients with ATC.
Methods
The present study is based on a retrospective review of clinical data of patients with ATC treated over the last decade in a tertiary referral center.
Results
Between January 1998 and December 2010, 31 patients (13 males: 18 females) with a mean age of 74 years (range: 54–90 years) had a diagnosis of ATC made on fine-needle aspiration (n = 29) or biopsy (n = 2). Eight patients underwent total thyroidectomy and lymph node dissection, and five patients had attempted surgery but the procedure was abandoned because of inoperability. Airway compromise was clinically apparent in 11 patients. Five patients had tracheal stents inserted, with a median survival of 2 months (range: 1–36 months). In the whole cohort, 29 patients died of the disease, with a mean survival of 7 months (range: 1–36 months).
Conclusions
Survival of patients with undifferentiated thyroid cancer is severely compromised by airway obstruction. Palliation with tracheal stenting can rescue catastrophic airway obstruction but offers minimal survival benefit.
References
Gilliland FD, Hunt WC, Morris DM et al (1997) Prognostic factors for thyroid carcinoma. A population-based study of 15,698 cases from the Surveillance, Epidemiology and End Results (SEER) Program 1973–1991. Cancer 79:564–573
Kebebew E, Greenspan FS, Clark OH et al (2005) Anaplastic thyroid carcinoma. Treatment outcome and prognostic factors. Cancer 103:1330–1335
Kitamura Y, Shimizu K, Nagahama M et al (1999) Immediate causes of death in thyroid carcinoma: clinicopathological analysis of 161 fatal cases. J Clin Endocrinol Metab 84:4043–4049
Tan RK, Finley RK 3rd, Driscoll D et al (1995) Anaplastic carcinoma of the thyroid: a 24-year experience. Head Neck 17:41–47 discussion 47–48
Giuffrida D, Gharib H (2000) Anaplastic thyroid carcinoma: current diagnosis and treatment. Ann Oncol 11:1083–1089
O’Neill JP, O’Neill B, Condron C et al (2005) Anaplastic (undifferentiated) thyroid cancer: improved insight and therapeutic strategy into a highly aggressive disease. J Laryngol Otol 119:585–591
Ribechini A, Bottici V, Chella A et al (2006) Interventional bronchoscopy in the treatment of tracheal obstruction secondary to advanced thyroid cancer. J Endocrinol Invest 29:131–135
Tsutsui H, Kubota M, Yamada M et al (2008) Airway stenting for the treatment of laryngotracheal stenosis secondary to thyroid cancer. Respirology 13:632–638
Ito Y, Nikiforov YE, Schlumberger M et al (2013) Increasing incidence of thyroid cancer: controversies explored. Nat Rev Endocrinol 9:178–184
Nel CJ, van Heerden JA, Goellner JR et al (1985) Anaplastic carcinoma of the thyroid: a clinicopathologic study of 82 cases. Mayo Clin Proc 60:51–58
Besic N, Auersperg M, Us-Krasovec M et al (2001) Effect of primary treatment on survival in anaplastic thyroid carcinoma. Eur J Surg Oncol 27:260–264
Junor EJ, Paul J, Reed NS (1992) Anaplastic thyroid carcinoma: 91 patients treated by surgery and radiotherapy. Eur J Surg Oncol 18:83–88
Passler C, Scheuba C, Prager G et al (1999) Anaplastic (undifferentiated) thyroid carcinoma (ATC). A retrospective analysis. Langenbecks Arch Surg 384:284–293
Demeter JG, De Jong SA, Lawrence AM et al (1991) Anaplastic thyroid carcinoma: risk factors and outcome. Surgery 110:956–961 discussion 961–953
Tennvall J, Lundell G, Hallquist A et al (1994) Combined doxorubicin, hyperfractionated radiotherapy, and surgery in anaplastic thyroid carcinoma. Report on two protocols. The Swedish Anaplastic Thyroid Cancer Group. Cancer 74:1348–1354
Wassermann K, Eckel HE, Michel O et al (1996) Emergency stenting of malignant obstruction of the upper airways: long-term follow-up with two types of silicone prostheses. J Thorac Cardiovasc Surg 112:859–866
Shiraishi T, Kawahara K, Shirakusa T et al (1998) Stenting for airway obstruction in the carinal region. Ann Thorac Surg 66:1925–1929
Hopkins C, Stearns M, Watkinson AF (2001) Palliative tracheal stenting in invasive papillary thyroid carcinoma. J Laryngol Otol 115:935–937
Duro da Costa J, Dionisio J (2002) Bronchoscopic treatment in palliation of airway invasion of thyroid cancer (abstract). J Bronchol 9:247
Wood DE, Liu YH, Vallieres E et al (2003) Airway stenting for malignant and benign tracheobronchial stenosis. Ann Thorac Surg 76:167–172 discussion 173–164
Noppen M, Poppe K, D’Haese J et al (2004) Interventional bronchoscopy for treatment of tracheal obstruction secondary to benign or malignant thyroid disease. Chest 125:723–730
Zakaluzny SA, Lane JD, Mair EA (2003) Complications of tracheobronchial airway stents. Otolaryngol Head Neck Surg 128:478–488
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rajeev, P., Ezzat, T., Slade, M. et al. Tracheal Stenting has Minimal Impact on Survival in Anaplastic Thyroid Carcinoma. World J Surg 37, 2589–2593 (2013). https://doi.org/10.1007/s00268-013-2173-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-013-2173-8