Anaplastic (undifferentiated) thyroid cancer: improved insight and therapeutic strategy into a highly aggressive disease.
BACKGROUND
This review article discusses the clinical and diagnostic implications of anaplastic thyroid cancer, recognizing the aggressive nature of the disease and extensive disease progression upon diagnosis. Standard treatment strategies (surgical, chemotherapy, radiation) are discussed, comparing adjuvant and neo-adjuvant regimens and the emergence of tumour resistance with expression of multidrug resistance pumps. We question the pathological evolution of anaplasia as a 'de novo' disease or a post malignant transformation or dedifferentiation and the therapeutic implications of p53 mutation. Future treatment options are reviewed with an emphasis on specific molecular targets responsible for the neoplastic phenotype.


METHODS
An electronic search on Medline and Pubmed was performed under 'anaplastic thyroid carcinoma', 'anaplastic thyroid carcinogenesis', 'anaplastic thyroid carcinoma treatment reviews'. Relevant papers were systematically reviewed from 1965 to present.
O'Neill
J P
JP
Department of Surgery and Otolaryngology, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland. joneill@rcsi.ie
O'Neill
B
B
Condron
C
C
Walsh
M
M
Bouchier-Hayes
D
D
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002277:Carcinoma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D019008:Drug Resistance, Neoplasm; D006801:Humans; D037981:Neck Dissection; D020360:Neoadjuvant Therapy; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D013965:Thyroidectomy
D000970:Antineoplastic Agents