Volume 148, Issue 4 p. 564-571
Endocrine Surgery

Aggressive Surgical Resection of Anaplastic Thyroid Carcinoma May Provide Long-term Survival in Selected Patients

Ryan F. Brown MD

Ryan F. Brown MD

Department of Head and Neck Surgery, Kaiser Permanente, Denver, Colorado, USA

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Yadranko Ducic MD, FRCS

Corresponding Author

Yadranko Ducic MD, FRCS

Department of Otolaryngology–Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA

Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas, USA

Corresponding Author: Yadranko Ducic, MD, Otolaryngology and Facial Plastic Surgery Associates, 923 Pennsylvania Ave, Ste 100, Fort Worth, TX 76104, USA Email: [email protected]Search for more papers by this author
First published: 08 February 2013
Citations: 1
No sponsorships or competing interests have been disclosed for this article.

Abstract

Objective

In this study, we present our experience with aggressive surgical treatment in selected patients with anaplastic thyroid cancer with extrathyroidal extension.

Study Design

Case series with chart review.

Setting

Tertiary care referral center.

Subjects and Methods

Retrospective chart review of all patients with anaplastic thyroid cancer surgically treated by the senior author from January 1998 to July 2012.

Results

A total of 38 cases of anaplastic thyroid cancer were treated (21 male and 17 female). The mean age was 64.5 years. Twenty-two patients were considered surgically unresectable (18 had distant metastases and 4 had extrathyroidal extension of cancer lateral to carotid arteries) and underwent biopsy with or without tracheostomy. The remaining 16 patients underwent surgical resection with curative intent. Fourteen of these patients underwent postoperative radiation therapy. None of these 16 patients developed local recurrence. Six developed distant metastasis at an average follow-up of 3.2 months, 1 died of an unrelated myocardial infarction at 3 months, 2 were lost to follow-up, and 7 remain disease free with an average follow-up of 4.8 years (range, 9 months to 8 years). Of those patients who underwent complete surgical resection followed by postoperative radiation, 7 of 14 (50%) are still alive, with a mean follow-up of 4.8 years.

Conclusion

Selected patients with anaplastic thyroid cancer with extrathyroidal extension (stage IVB) who show no distant metastases by computed tomography or positron emission tomography scans and who do not have tumor extending lateral to the carotid arteries are candidates for complete surgical resection.