Zaki Antonio Taissoun Aslan
Medellin Cancer Institute
Colombia
Title: Anaplastic thyroid cancer: Multimodal treatment results
Biography
Biography: Zaki Antonio Taissoun Aslan
Abstract
Introduction: Anaplastic thyroid cancer is a rare and lethal disease. It accounts for 1-2% of thyroid malignancies, but specific mortality is higher than 90%. It is an aggressive loco-regional disease with a high metastatic capacity. There is no agreement concerning the best treatment. We analyzed the results of treatment in a Mestizo population treated in the National Cancer Institute (Mexico). Methods: 1,581 files of thyroid carcinomas were reviewed; of these, 29(1.83%) had anaplastic thyroid carcinoma. We analyzed Demographic variables, clinical manifestations, tumor characteristics and treatments. Results: The median age was 64.5±13.2 years. Females were more affected (female/male ratio: 2.6:1); 21 cases occurred in women (72.4%), and 8 in males (27.6%). The most common manifestations were neck enlargement (93.10%) and hoarseness (71.31%). The median tumor size was 8 cm (range: 4-20 cm). The percentage of cases, which presented in clinical stage IV-A was 10.3%, with 62.1% presenting in clinical stage IV-b and 27.6% presenting in clinical stage VI-c. Complete resection (R0) (p=0.05), radiation doses of higher than 33.1 Gy (p=0.04), and multimodal therapy were associated with better survival. Surgery plus radiotherapy with or without systemic treatment (p=0.006). The median overall survival was 119 days (IC 95%, 36.3-201.6). Six-month, one-year and two-year survival was 37.9%, 21% and 13%, respectively. Conclusion: Complete surgical resection is associated with better survival but is very difficult to achieve due to aggressive biological behavior. Multimodal therapy is associated with better survival and a better quality of life. There is a need for more effective systemic treatments as extensive surgical resections have little overall benefit in highly invasive and metastatic disease