title: Efficacy of combined treatment for anaplastic thyroid carcinoma: results of a multinstitutional retrospective analysis.
abstract: BACKGROUND
  Anaplastic thyroid carcinoma (ATC) is a killer tumor, characterized by local invasiveness, risk of recurrence and very poor prognosis. Due to its rarity, clinical case studies concerning management are lacking.
  
  
  METHODS
  We retrospectively reviewed a multinstitutional clinical series of 114 consecutive patients treated between 1996 and 2012 for ATC. The outcomes of a combined treatment were analyzed considering the impact of surgery and radiotherapy on survival.
  
  
  RESULTS
  Patients were divided in groups A and B considering tumor size (tumor lesser and larger than 5 cm). Surgery was carried out in 71 patients, radiotherapy in 89 patients. Tracheostomy and endoprothesis were used respectively in 48.7% and in 25.6% of patients. The mean survival was 5.35 (±3.2) months with no significant difference in group A vs group B. A better survival was observed in both groups of patients undergone a surgical treatment compared to no treated patients (p = 0.001 and p = 0.0001) or to patients undergone radiotherapy alone (p = 0.047 and p = 0.0001). Combination of surgery and radiotherapy significantly improved outcome (p = 0.017).
  
  
  CONCLUSIONS
  Despite disappointing results from single therapeutic approach, multimodal strategy has progressively become the treatment of choice in ATC, with surgery being the cornerstone of the management.
  
  
  CONCLUSIONS
  Although dismal prognosis, the combined treatment might significantly improves locoregional disease control, achieving acceptable survival in selected patients and adequate palliation of the symptoms.
authors.affiliation: Department of Anaesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen. G. Orsini 42, 80132 Napoli, Italy. Electronic address: giovanni.conzo@unina2.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Conzo
authors.affiliation: University of Perugia, Medical School, General Surgery and Surgical Specialties Unit, S. Maria University Hospital, Terni, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Polistena
authors.affiliation: Department of Surgical Sciences, University of Cagliari, Italy.
authors.forename: Pietro Giorgio
authors.initials: PG
authors.lastname: Calò
authors.affiliation: Department of Surgery "P. Valdoni", University of Rome "La Sapienza" Policlinico Umberto I, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bononi
authors.affiliation: Department of Anaesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen. G. Orsini 42, 80132 Napoli, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Gambardella
authors.affiliation: Department of Anaesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen. G. Orsini 42, 80132 Napoli, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Mauriello
authors.affiliation: Department of Anaesthesiologic, Surgical and Emergency Sciences, VII Division of General and Endocrine Surgery, Second University of Naples, Via Gen. G. Orsini 42, 80132 Napoli, Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Tartaglia
authors.affiliation: University of Perugia, Medical School, General Surgery and Surgical Specialties Unit, S. Maria University Hospital, Terni, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Avenia
authors.affiliation: University of Perugia, Medical School, General Surgery and Surgical Specialties Unit, S. Maria University Hospital, Terni, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sanguinetti
authors.affiliation: Department of Surgical Sciences, University of Cagliari, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Medas
authors.affiliation: Department of Surgery "P. Valdoni", University of Rome "La Sapienza" Policlinico Umberto I, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: de Toma
authors.affiliation: University of Perugia, Medical School, General Surgery and Surgical Specialties Unit, S. Maria University Hospital, Terni, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Avenia
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D065646:Thyroid Carcinoma, Anaplastic / Q000401:mortality / Q000628:therapy*; D013964:Thyroid Neoplasms / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome
keywords: Anaplastic thyroid carcinoma; Prognosis; Radiotherapy; Surgery; Survival