title: Tracheal stenting has minimal impact on survival in anaplastic thyroid carcinoma.
abstract: BACKGROUND
  Anaplastic thyroid carcinoma (ATC) is the most aggressive form of thyroid cancer and it has an extremely poor prognosis. Rapid airway compromise is the main cause of death in patients with ATC.
  
  
  METHODS
  The present study is based on a retrospective review of clinical data of patients with ATC treated over the last decade in a tertiary referral center.
  
  
  RESULTS
  Between January 1998 and December 2010, 31 patients (13 males: 18 females) with a mean age of 74 years (range: 54-90 years) had a diagnosis of ATC made on fine-needle aspiration (n = 29) or biopsy (n = 2). Eight patients underwent total thyroidectomy and lymph node dissection, and five patients had attempted surgery but the procedure was abandoned because of inoperability. Airway compromise was clinically apparent in 11 patients. Five patients had tracheal stents inserted, with a median survival of 2 months (range: 1-36 months). In the whole cohort, 29 patients died of the disease, with a mean survival of 7 months (range: 1-36 months).
  
  
  CONCLUSIONS
  Survival of patients with undifferentiated thyroid cancer is severely compromised by airway obstruction. Palliation with tracheal stenting can rescue catastrophic airway obstruction but offers minimal survival benefit.
authors.affiliation: Department of Endocrine Surgery, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, UK, malumols@live.co.uk.
authors.forename: Parameswaran
authors.initials: P
authors.lastname: Rajeev
authors.forename: Tarek
authors.initials: T
authors.lastname: Ezzat
authors.forename: Mark
authors.initials: M
authors.lastname: Slade
authors.forename: Gregory Paul
authors.initials: GP
authors.lastname: Sadler
authors.forename: Radu
authors.initials: R
authors.lastname: Mihai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate; D065646:Thyroid Carcinoma, Anaplastic; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D013965:Thyroidectomy; D014132:Trachea
references.citation: Cancer. 1997 Feb 1;79(3):564-73
references.pmid: 9028369
references.citation: Ann Oncol. 2000 Sep;11(9):1083-9
references.pmid: 11061600
references.citation: Cancer. 1994 Aug 15;74(4):1348-54
references.pmid: 8055459
references.citation: Nat Rev Endocrinol. 2013 Mar;9(3):178-84
references.pmid: 23358352
references.citation: Langenbecks Arch Surg. 1999 Jun;384(3):284-93
references.pmid: 10437618
references.citation: Mayo Clin Proc. 1985 Jan;60(1):51-8
references.pmid: 3965822
references.citation: J Endocrinol Invest. 2006 Feb;29(2):131-5
references.pmid: 16610238
references.citation: Ann Thorac Surg. 1998 Dec;66(6):1925-9
references.pmid: 9930470
references.citation: J Thorac Cardiovasc Surg. 1996 Oct;112(4):859-66
references.pmid: 8873710
references.citation: J Laryngol Otol. 2001 Nov;115(11):935-7
references.pmid: 11779317
references.citation: Head Neck. 1995 Jan-Feb;17(1):41-7; discussion 47-8
references.pmid: 7883548
references.citation: Otolaryngol Head Neck Surg. 2003 Apr;128(4):478-88
references.pmid: 12707649
references.citation: J Laryngol Otol. 2005 Aug;119(8):585-91
references.pmid: 16102210
references.citation: Chest. 2004 Feb;125(2):723-30
references.pmid: 14769757
references.citation: Surgery. 1991 Dec;110(6):956-61; discussion 961-3
references.pmid: 1745983
references.citation: Cancer. 2005 Apr 1;103(7):1330-5
references.pmid: 15739211
references.citation: Eur J Surg Oncol. 2001 Apr;27(3):260-4
references.pmid: 11373102
references.citation: Ann Thorac Surg. 2003 Jul;76(1):167-72; discussion 173-4
references.pmid: 12842534
references.citation: Respirology. 2008 Sep;13(5):632-8
references.pmid: 18513246
references.citation: Eur J Surg Oncol. 1992 Apr;18(2):83-8
references.pmid: 1582515
references.citation: J Clin Endocrinol Metab. 1999 Nov;84(11):4043-9
references.pmid: 10566647