title: Outcomes in patients with poorly differentiated thyroid carcinoma.
abstract: BACKGROUND
  Poorly differentiated thyroid cancer (PDTC) accounts for only 1-15% of all thyroid cancers. Our objective is to report outcomes in a large series of patients with PDTC treated at a single tertiary care cancer center.
  
  
  METHODS
  A total of 91 patients with primary PDTC were treated by initial surgery with or without adjuvant therapy at Memorial Sloan-Kettering Cancer Center from 1986 to 2009. Outcomes were calculated by the Kaplan-Meier method. Clinicopathological characteristics were compared for PDTC patients who died of disease to those who did not by the χ(2) test. Factors predictive of disease-specific survival (DSS) were calculated by univariate and multivariate analysis using the log rank and Cox proportional hazards method, respectively.
  
  
  RESULTS
  With a median follow-up of 50 months, the 5-year overall survival and DSS were 62 and 66%, respectively. The 5-year locoregional and distant control were 81 and 59%, respectively. Of 27 disease-specific deaths, 23 (85%) were due to distant disease. Age ≥ 45 years, pathological tumor size >4 cm, extrathyroidal extension, higher pathological T stage, positive margins, and distant metastases (M1) were predictive of worse DSS on univariate analysis. Multivariate analysis showed that only pT4a stage and M1 were independent predictors of worse DSS.
  
  
  CONCLUSIONS
  With appropriate surgery and adjuvant therapy, excellent locoregional control can be achieved in PDTC. Disease-specific deaths occurred due to distant metastases and rarely due to uncontrolled locoregional recurrence in this series.
authors: Departments of Head and Neck Surgery (T.I., I.N., F.L.P., A.R.S., S.G.P., J.P.S., I.G.) and Pathology (R.G.), Memorial Sloan-Kettering Cancer Center, New York, New York 10065; Department of Pathology (D.L.C.), Cleveland Clinic, Weston, Florida 33331; and Department of Endocrinology (R.M.T.), Memorial Sloan-Kettering Cancer Center, New York, New York 10065.
authors: T
authors: T
authors: Ibrahimpasic
authors: R
authors: R
authors: Ghossein
authors: D L
authors: DL
authors: Carlson
authors: I
authors: I
authors: Nixon
authors: F L
authors: FL
authors: Palmer
authors: A R
authors: AR
authors: Shaha
authors: S G
authors: SG
authors: Patel
authors: R M
authors: RM
authors: Tuttle
authors: J P
authors: JP
authors: Shah
authors: I
authors: I
authors: Ganly
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D013965:Thyroidectomy / Q000706:statistics & numerical data; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes