title: The effect of surgery and radiotherapy on outcome of anaplastic thyroid carcinoma.
abstract: BACKGROUND
  Anaplastic thyroid carcinoma (ATC) is an aggressive rare tumor. We analyzed our experience for prognosis and the effect of surgery and radiotherapy on patients with ATC.
  
  
  METHODS
  We conducted a retrospective review of all patients (n = 67) with ATC treated at a tertiary care center from 1969 to 1999. Survivor median follow-up was 51 months. Tumor and patient characteristics and therapy were assessed for effect on survival by multivariate analysis.
  
  
  RESULTS
  Patients presented with a neck mass (99%), change of voice (51%), dysphagia (33%), and dyspnea (28%). Surgery was performed in 44 of 67 patients, with 12 complete resections. The 6-month and 1- and 3-year survival rates were 92%, 92%, and 83% after complete resection; 53%, 35%, and 0% after debulking; and 22%, 4%, and 0% after no resection, respectively (P < .0001). A radiation dose of >45 Gy improved survival as compared with a lower dose (P = .02). Multivariate analysis showed that age < or = 70 years, absence of dyspnea or dysphagia at presentation, a tumor size < or = 5 cm, and any surgical resection improved survival (P < .05).
  
  
  CONCLUSIONS
  Candidates for surgery with curative intent for ATC are patients < or = 70 years, tumors < or = 5 cm, and no distant disease. Radiotherapy >45 Gy improves outcome.
authors.affiliation: Department of Surgery, Medical Center Leeuwarden, The Netherlands.
authors.forename: Jean-Pierre E N
authors.initials: JP
authors.lastname: Pierie
authors.forename: Alona
authors.initials: A
authors.lastname: Muzikansky
authors.forename: Randall D
authors.initials: RD
authors.lastname: Gaz
authors.forename: William C
authors.initials: WC
authors.lastname: Faquin
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Ott
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D013964:Thyroid Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D016896:Treatment Outcome