Treatment and Prognosis of Anaplastic Thyroid Carcinoma: Experience from a Single Institution in China

被引:32
|
作者
Sun, Chuanzheng [1 ]
Li, Qiuli [2 ,3 ]
Hu, Zedong [1 ]
He, Jiehua [3 ,4 ]
Li, Chao [5 ]
Li, Guojun [6 ]
Tao, Xiaofeng [7 ]
Yang, Ankui [2 ,3 ]
机构
[1] Kunming Med Univ, Affiliated Hosp 3, Dept Head & Neck Surg, Kunming, Yunnan, Peoples R China
[2] Sun Yat Sen Univ, Ctr Canc, Dept Head & Neck Surg, Guangzhou 510275, Guangdong, Peoples R China
[3] State Key Lab Oncol South China, Guangzhou, Guangdong, Peoples R China
[4] Sun Yat Sen Univ, Ctr Canc, Dept Pathol, Guangzhou 510275, Guangdong, Peoples R China
[5] Tumor Hosp Sichuan Prov, Dept Head & Neck Surg, Chengdu, Sichuan, Peoples R China
[6] Univ Texas MD Anderson Canc Ctr, Dept Head & Neck Surg, Houston, TX 77030 USA
[7] Shanghai Jiao Tong Univ, Shanghai Peoples Hosp 9, Sch Med, Dept Radiol, Shanghai 200030, Peoples R China
来源
PLOS ONE | 2013年 / 8卷 / 11期
基金
中国国家自然科学基金;
关键词
TREATMENT OUTCOMES; SURVIVAL; CANCER; RADIOTHERAPY; SURGERY; NEUTROPHILIA; DOXORUBICIN; MANAGEMENT;
D O I
10.1371/journal.pone.0080011
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: Anaplastic thyroid carcinoma (ATC), a highly aggressive malignancy, has a poor prognosis, and the consensus on the most effective treatment is needed. Methods: Clinical data from all ATC patients treated in our institution over a 30-year period (between May 1980 and May 2010) were analyzed retrospectively with regard to mortality and survival rates (Kaplan-Meier). Multivariate analysis was performed using a Cox proportional hazards model. Results: Sixty cases were analyzed. The overall 1- and 3-year survival rates were 35.0% and 22.9%, respectively. Univariate analysis showed that the best prognosis was seen in patients younger than 55 years, those without distant metastases, those with white blood cell (WBC) counts < 10.0 x 10(9)/L or blood platelet (PLT) counts < 300.0 x 10(9)/L at presentation, those who did not receive chemotherapy, and those who received radiotherapy doses >= 40 Gy or underwent surgery plus postoperative radiotherapy. According to multivariate analysis, the WBC count at first presentation and the type of therapeutic regimen independently influenced survival. Conclusions: We found that the elevated peripheral PLT count may be an adverse prognostic factor of ATC patients. The prognosis for ATC is especially poor for patients with distant metastasis, a WBC count >= 10.0x10(9)/L, a PLT count >= 300.0 x 10(9)/L, or age >= 55 years. WBC count at presentation and surgery with or without postoperative radiotherapy independently influenced the prognosis. Intensive treatment combining surgery with postoperative radiotherapy is recommended for ATC patients with stage IVA/B disease.
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页数:8
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