Influence of risk grouping on therapeutic decisions in patients with anaplastic thyroid carcinoma.
We investigated prognostic factors in 42 anaplastic thyroid carcinoma (ATC) patients from a single institution over a 30-year period and explored the use of risk grouping to guide therapeutic decisions. Univariable and multivariable differences in overall survival (OS) were evaluated using the Kaplan-Meier method and the log-rank test as well as Cox proportional hazards model. Risk grouping in making therapeutic decisions for ATC patients was explored. The 1- and 3-year OS rates were 28.6 % and 18.5 %, respectively. Univariate analysis indicated that 4 pre-therapeutic factors of patients were related to poorer prognoses: age ≥ 55 years, white blood cell count ≥ 10.0 × 10(9)/L, blood platelet count ≥ 300.0 × 10(9)/L and advanced clinical tumor-node-metastasis stage. These factors were used to calculate the risk indices. Patients with total risk index scores of no more than 1 were considered to be in the low-risk group, and patients with scores ≥ 2 were considered to be in the high-risk group. The patients in the low-risk group had significantly better 1- and 3-year OS rates (90.9 % and 63.6 %, respectively) than those in the high-risk group (6.5 % and 3.2 %, respectively). Risk group and therapeutic regimen were the 2 factors that independently influenced survival according to multivariable analysis. Surgery that was combined with postoperative radiotherapy significantly benefited the patients in the low-risk group rather than the patients in the high-risk group. Risk grouping was a helpful tool of evaluating the prognoses and guiding the treatment of ATC patients.
Department of Head and Neck Surgery, The Third Affiliated Hospital of Kunming Medical University, 519 Kunzhou Road, Kunming, China.|Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China.|State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, China.
Chuanzheng
C
Sun
Department of Head and Neck Surgery, The Tumor Hospital of Sichuan Province, 55 Renmin Road South, Chengdu, China.
Chao
C
Li
Department of Head and Neck Surgery, The Third Affiliated Hospital of Kunming Medical University, 519 Kunzhou Road, Kunming, China.
Zedong
Z
Hu
Department of Head and Neck Surgery, The Third Affiliated Hospital of Kunming Medical University, 519 Kunzhou Road, Kunming, China.
Xiaojiang
X
Li
State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, China.|Department of Pathology, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, China.
Jiehua
J
He
Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China.|State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, China.
Ming
M
Song
Department of Head and Neck Surgery, Unit 1445, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Guojun
G
Li
Department of General Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei, China.
Fenghua
F
Zhang
Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China. liql@sysucc.org.cn.|State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou, China. liql@sysucc.org.cn.
Qiuli
Q
Li
D002681:China / Q000453:epidemiology; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate / Q000639:trends; D065646:Thyroid Carcinoma, Anaplastic / Q000401:mortality / Q000628:therapy*