title: Thyroid anaplastic carcinoma: the impact of multimodality treatment on survival. The experience of a referral center for endocrine surgery.
abstract: OBJECTIVE
  Anaplastic thyroid carcinoma (ATC) is characterized by local invasiveness, risk of recurrence and very poor prognosis.
  
  
  METHODS
  We retrospectively reviewed 79 consecutive patients treated between 1996 and 2012. We analysed the multimodality treatment of ATC considering the impact of surgery and radiotherapy on survival.
  
  
  RESULTS
  Patients were divided in groups A and B (tumor less and larger than 5 cm). Surgery was carried out in 44 patients, radiotherapy in 48 patients. Tracheostomy and endoprosthesis were used respectively in 48.1% and in 25.3% of patients. The mean survival was 5.35 (± 3.2) months with no significant difference in group A vs. group B. Considering patients undergone surgery, significant impact on survival was observed comparing A vs. B (P=0.013). Combination of surgery and radiotherapy significantly improves outcome comparing A vs. B (P=0.017). Improvement in survival compared to no treatment at all was observed in both groups respectively for surgery (P=0.001 and P=0.0001) and radiotherapy (P=0.047 and P=0.0001).
  
  
  CONCLUSIONS
  Although the severity of prognosis of ATC, multimodality treatment still significantly improves local control of the disease achieving acceptable survival in selected patients and adequate palliation of symptoms for the others. Surgery is still a fundamental treatment.
authors: University of Perugia, Medical School Endocrine Surgery Unit S. Maria University Hospital Terni, Terni, Italy - apolis74yahoo.it.
authors: A
authors: A
authors: Polistena
authors: M
authors: M
authors: Monacelli
authors: R
authors: R
authors: Lucchini
authors: R
authors: R
authors: Triola
authors: C
authors: C
authors: Conti
authors: S
authors: S
authors: Avenia
authors: M
authors: M
authors: Sole Di Patrizi
authors: I
authors: I
authors: Barillaro
authors: A
authors: A
authors: Boccolini
authors: A
authors: A
authors: Sanguinetti
authors: N
authors: N
authors: Avenia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant / Q000379:methods; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D012720:Severity of Illness Index; D065646:Thyroid Carcinoma, Anaplastic / Q000175:diagnosis / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D014139:Tracheostomy / Q000379:methods; D016896:Treatment Outcome