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. 2013 Sep 1;119(17):3133-9.
doi: 10.1002/cncr.28187. Epub 2013 Jul 9.

Marginal treatment benefit in anaplastic thyroid cancer

Megan R Haymart  1 , Mousumi Banerjee, Huiying Yin, Francis Worden, Jennifer J Griggs
Affiliations

Marginal treatment benefit in anaplastic thyroid cancer

Megan R Haymart et al. Cancer. .

Abstract

Background: Because anaplastic thyroid cancer is a rare malignancy with a high mortality rate, the benefit of multimodality treatment was evaluated.

Methods: Overall survival was determined in the 2742 patients captured by the National Cancer Database who were diagnosed with anaplastic thyroid cancer between 1998 and 2008. Kaplan-Meier analysis and then Cox proportional hazard regression was performed, controlling for patient characteristics and treatment.

Results: Only older age (adjusted hazard ratio [AHR] for ≥ 85 years = 3.43, 95% confidence interval [CI] = 2.34-5.03; for 75-84 years, AHR = 2.85, 95% CI = 1.97-4.11; for 65-74 years, AHR = 2.20, 95% CI = 1.53-3.15; for 45-64 years, AHR = 2.08, 95% CI = 1.47-2.95) and omission of treatment were associated with greater mortality (omission of surgery: AHR = 1.79, 95% CI = 1.61-1.99; omission of radiation therapy: AHR = 1.56; 95% CI = 1.41-1.73; and omission of chemotherapy: AHR = 1.28, 95% CI = 1.15-1.43). In subgroup analysis of patients with American Joint Committee on Cancer stage IVA, IVB, and IVC anaplastic thyroid cancer, combination therapy with surgery, radiation, and chemotherapy was associated a difference in median survival of months.

Conclusions: Multimodality management of anaplastic thyroid cancer results in a marginal treatment benefit. The poor overall survival of all anaplastic thyroid cancer patients, regardless of treatment, emphasizes the need for informed patients whose preferences are incorporated into treatment decision-making.

Keywords: anaplastic thyroid cancer; cancer; survival; thyroid; treatment.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Kaplan-Meier curves show (A) overall survival of patients with anaplastic thyroid cancer undergoing total thyroidectomy versus lobectomy versus no thyroid surgery, and overall survival of patients with anaplastic thyroid cancer on the basis of receipt of (B) radiation and (C) chemotherapy.
Figure 2
Figure 2
Overall survival is shown for patients with anaplastic thyroid cancer who had American Joint Committee on Cancer stage IVA, IVB, and IVC cancer.
See this image and copyright information in PMC

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