Multimodality Treatment Improves Locoregional Control, Progression-Free and Overall Survival in Patients with Anaplastic Thyroid Cancer: A Retrospective Cohort Study Comparing Oncological Outcomes and Morbidity between Multimodality Treatment and Limited Treatment

Pascal K C Jonker^{1

2}, John Turchini^{3

4

5}, Schelto Kruijff², Jia Feng Lin^{1

2}, Anthony J Gill^{3

6

7}, Thomas Eade⁸, Ahmad Aniss¹, Roderick Clifton-Bligh^{3

9}, Diana Learoyd^{3

9}, Bruce Robinson^{3

9}, Venessa Tsang^{3

9}, Anthony Glover^{1

3

10

11}, Stanley Sidhu^{1

3}, Mark Sywak^{12

13

14}

Affiliations

¹ University of Sydney Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, Australia.
² Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
³ Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
⁴ Douglass Hanly Moir Pathology, Macquarie Park, NSW, Australia.
⁵ Discipline of Pathology, MQ Health, Macquarie University, Macquarie Park, NSW, Australia.
⁶ NSW Health Pathology Department of Anatomical Pathology, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia.
⁷ Cancer Diagnsosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia.
⁸ Department of Radiation Oncology, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia.
⁹ Department of Endocrinology, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, Australia.
¹⁰ Endocrine Cancer Program, Cancer Theme, The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, 2010, Australia.
¹¹ St. Vincent's Clinical School, Faculty of Medicine, University of New South Wales Sydney, Sydney, NSW, 2052, Australia.
¹² University of Sydney Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, Australia. marksywak@nebsc.com.au.
¹³ Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia. marksywak@nebsc.com.au.
¹⁴ University of Sydney Endocrine Surgery Unit, AMA House, St Leonards, NSW, 2065, Australia. marksywak@nebsc.com.au.

PMID: 34032961
DOI: 10.1245/s10434-021-10146-3

Multimodality Treatment Improves Locoregional Control, Progression-Free and Overall Survival in Patients with Anaplastic Thyroid Cancer: A Retrospective Cohort Study Comparing Oncological Outcomes and Morbidity between Multimodality Treatment and Limited Treatment

Pascal K C Jonker et al. Ann Surg Oncol. 2021 Nov.

. 2021 Nov;28(12):7520-7530.

doi: 10.1245/s10434-021-10146-3. Epub 2021 May 25.

Authors

Affiliations

¹ University of Sydney Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, Australia.
² Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
³ Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
⁴ Douglass Hanly Moir Pathology, Macquarie Park, NSW, Australia.
⁵ Discipline of Pathology, MQ Health, Macquarie University, Macquarie Park, NSW, Australia.
⁶ NSW Health Pathology Department of Anatomical Pathology, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia.
⁷ Cancer Diagnsosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia.
⁸ Department of Radiation Oncology, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia.
⁹ Department of Endocrinology, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, Australia.
¹⁰ Endocrine Cancer Program, Cancer Theme, The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, 2010, Australia.
¹¹ St. Vincent's Clinical School, Faculty of Medicine, University of New South Wales Sydney, Sydney, NSW, 2052, Australia.
¹² University of Sydney Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, Australia. marksywak@nebsc.com.au.
¹³ Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia. marksywak@nebsc.com.au.
¹⁴ University of Sydney Endocrine Surgery Unit, AMA House, St Leonards, NSW, 2065, Australia. marksywak@nebsc.com.au.

PMID: 34032961
DOI: 10.1245/s10434-021-10146-3

Erratum in

Correction to: Multimodality Treatment Improves Locoregional Control, Progression-Free and Overall Survival in Patients with Anaplastic Thyroid Cancer: A Retrospective Cohort Study Comparing Oncological Outcomes and Morbidity between Multimodality Treatment and Limited Treatment.
Jonker PKC, Turchini J, Kruijff S, Lin JF, Gill AJ, Eade T, Aniss A, Clifton-Bligh R, Learoyd D, Robinson B, Tsang V, Glover A, Sidhu S, Sywak M. Jonker PKC, et al. Ann Surg Oncol. 2021 Dec;28(Suppl 3):891. doi: 10.1245/s10434-021-10440-0. Ann Surg Oncol. 2021. PMID: 34279756 No abstract available.

Abstract

Background: Patients with anaplastic thyroid cancer (ATC) have poor overall survival, and the optimal management approach remains unclear. The aim of this study is to evaluate our experience with multimodality (MMT) versus limited treatment (LT) for ATC.

Patients and methods: A cohort study of patients with ATC managed in a tertiary referral center was undertaken. The outcomes of MMT were compared with those of LT. The primary outcome measures were locoregional control and progression-free and overall survival. Secondary outcome measures were treatment-related complications and factors associated with improved survival.

Results: In total, 59 patients (35 females) with a median age of 73 years (range 39-99 years) and ATC stage IVA (n = 2), IVB (n = 28), or IVC (n = 29) were included. LT was utilized in 25 patients (42%), and 34 cases had MMT. MMT patients had a longer time of locoregional control (18.5 versus 1.9 months; p < 0.001), progression-free survival (3.5 versus 1.2 months; p < 0.001), and overall survival (6.9 versus 2.0 months; p < 0.001) when compared with LT. For patients with stage IVC ATC, locoregional control (p = 0.03), progression-free survival (p < 0.001), and overall survival (p < 0.001) were superior in the MMT cohort compared with LT. MMT had more treatment-related complications than LT (p < 0.001). An Eastern Cooperative Oncology Group performance status < 2 (HR 0.30; p = 0.001) and MMT (HR 0.35; p = 0.008) were associated with improved overall survival.

Conclusion: MMT is likely to improve locoregional control, progression-free survival, and overall survival in selected ATC patients including stage IVC tumors but comes with a greater complication risk.

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Comment in

ASO Author Reflections: Multimodality Treatment in Anaplastic Thyroid Cancer: Improving Survival Outcomes and Balancing Treatment Related Complications.
Jonker PKC, Sywak M. Jonker PKC, et al. Ann Surg Oncol. 2021 Nov;28(12):7531-7532. doi: 10.1245/s10434-021-10268-8. Epub 2021 Jun 15. Ann Surg Oncol. 2021. PMID: 34131820 No abstract available.

References

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Multimodality Treatment Improves Locoregional Control, Progression-Free and Overall Survival in Patients with Anaplastic Thyroid Cancer: A Retrospective Cohort Study Comparing Oncological Outcomes and Morbidity between Multimodality Treatment and Limited Treatment

Affiliations

Multimodality Treatment Improves Locoregional Control, Progression-Free and Overall Survival in Patients with Anaplastic Thyroid Cancer: A Retrospective Cohort Study Comparing Oncological Outcomes and Morbidity between Multimodality Treatment and Limited Treatment

Authors

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Erratum in

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References

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