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13.
Effect of primary treatment on survival in anaplastic thyroid carcinoma
Bešić, Nikola ...
Aims: Anaplastic thyroid carcinoma (ATC) is a facal disease despite combined treatment consisting of chemotherapy, radioterapy and surgery. The optimal sequence of treatment modalities is not known. ...The purpose of our retrospective non-randomized study was to find out whether timing of the treatment modality had any influence on survival, and to find out it primary surgery prolongs survival in comparison to primary chemotherapy and/or radiotherapy. Methods. From our database of 162 patients with ATC treated as the Institute of Oncology Ljubljana from 1972-98. 79 patients (26 men, 53 women; age: 40-86 years, mean age 65 years) were included in this reatrospective study. The 83 patients with distant metatases on admission, with the survival shorter than one month or patients without any treatment were excluded. The 79 patients were classified into (1) primary surgery group (n=26) and (2) primary chemotherapy and/or radiotherapy group (n=5), includingthe 12 patients in whom surgery was performed after chemotherapy and/or radiotherapy. The survival of both groups was compared by lon-rank testand group characteristics by ANOVA and chi-square test using SPSS program.Results: In comparison to the primary surgery group, the patients fromthe primary chemotherapy and/or radiotherapy group were older and had faster growing and larger tumours, which were not confined to the thyroid and more frequently had regional metastases. There was no differences in the survival of the two groups (P=0.017). Survival for longer than one year was observed in 25% of patients which primary surgery and in 21% of patients with primary chemotherapy and/or radiotherapy. The best results (50% survival at one year) were obtained in patients in whom the tumour was surgically removed after primary chemotherapy and radiotherapy. (Abstract truncated at 2000 characters).
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