title: Recurrence and Survival After Gross Total Removal of Resectable Undifferentiated or Poorly Differentiated Thyroid Carcinoma.
abstract: This study aimed to evaluate the recurrence and survival after initial curative-intent surgery of resectable anaplastic thyroid cancer (ATC) and poorly differentiated thyroid cancer (PDTC).
  
  
  
  A retrospective analysis was conducted on patients with ATC and PDTC who had been treated between 1985 and 2013. Among them, 119 patients who had undergone surgery with curative intent were included in this study. The outcome measures included the clinical response to treatment and the recurrence rates of three separate thyroid cancer groups: ATC, differentiated thyroid cancer (DTC) with anaplastic foci, and PDTC.
  
  
  
  Initial remission was achieved in 100 (84.0%) patients, with higher percentages in patients with DTC with anaplastic foci (97.8%) and PDTC (96.7%) compared with ATC (60.5%). The overall recurrence rate after initial remission was 30.8% in ATC, 25.9% in PDTC, and 6.7% in DTC with anaplastic foci. Pathologic diagnosis, preexisting goiter or tumors, along with tracheal and lymphatic/vascular invasion were correlated with recurrence (p < 0.001; p = 0.001, 0.006, 0.003, and 0.016, respectively). All patients without initial remission died due to local failure, and most patients with recurrence, apart from two PDTC patients, had distant metastasis. Overall mortality after initial curative-intent surgery was 58.1% in ATC, 8.7% in DTC with anaplastic foci, and 20% in PDTC.
  
  
  
  The initial remission of resectable tumors was higher and the recurrence rate was lower in DTC with anaplastic foci and PDTC compared with ATC. Careful monitoring of the development of distant metastasis is necessary, especially in patients with aggressive pathology with tracheal and lymphovascular invasion.
authors.affiliation: 1 Department of Otorhinolaryngology-Head and Neck Surgery and Cancer Research Institute, Seoul National University College of Medicine , Seoul, Korea.|2 Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine , Seoul, Korea.
authors.forename: Doh Young
authors.initials: DY
authors.lastname: Lee
authors.affiliation: 3 Department of Pathology, Seoul National University College of Medicine , Seoul, Korea.
authors.forename: Jae-Kyung
authors.initials: JK
authors.lastname: Won
authors.affiliation: 4 Department of Internal Medicine, Seoul National University College of Medicine , Seoul, Korea.|5 Department of Internal Medicine, Kangwon National University Hospital , Chuncheon, Korea.
authors.forename: Hoon Sung
authors.initials: HS
authors.lastname: Choi
authors.affiliation: 4 Department of Internal Medicine, Seoul National University College of Medicine , Seoul, Korea.
authors.forename: Do Joon
authors.initials: do J
authors.lastname: Park
authors.affiliation: 3 Department of Pathology, Seoul National University College of Medicine , Seoul, Korea.
authors.forename: Kyeong Cheon
authors.initials: KC
authors.lastname: Jung
authors.affiliation: 1 Department of Otorhinolaryngology-Head and Neck Surgery and Cancer Research Institute, Seoul National University College of Medicine , Seoul, Korea.
authors.forename: Myung-Whun
authors.initials: MW
authors.lastname: Sung
authors.affiliation: 1 Department of Otorhinolaryngology-Head and Neck Surgery and Cancer Research Institute, Seoul National University College of Medicine , Seoul, Korea.
authors.forename: Kwang Hyun
authors.initials: KH
authors.lastname: Kim
authors.affiliation: 1 Department of Otorhinolaryngology-Head and Neck Surgery and Cancer Research Institute, Seoul National University College of Medicine , Seoul, Korea.
authors.forename: J Hun
authors.initials: JH
authors.lastname: Hah
authors.affiliation: 4 Department of Internal Medicine, Seoul National University College of Medicine , Seoul, Korea.
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate; D065646:Thyroid Carcinoma, Anaplastic / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome