title: Treatment and Prognosis of Anaplastic Thyroid Carcinoma: A Clinical Study of 50 Cases.
abstract: BACKGROUND
  Although anaplastic thyroid carcinoma (ATC) is rare, it is one of the most aggressive human cancers. The optimal multimodal therapy policy of ATC is still debated, and a standardized treatment strategy remains to be established. This study aimed to evaluate the management aspect and prognosis of ATC.
  
  
  METHODS
  The data were analyzed retrospectively for 50 patients with ATC to evaluate the clinical characters, management and factors influencing survival. Survival analysis was performed by Kaplan-Merier method and log-rank test, and multivariate analysis was performed using Cox proportional hazard model.
  
  
  RESULTS
  The 1-year and 2-year overall survival rates (OS) were 48.0% and 26.0% respectively in all patients, with the 2-year OS of 40.0% and 31.0% and 6.3% for stage IVA, IVB and IVC respectively (P <0.05). In stage IVA and IVB patients, combined surgery with radiotherapy improved overall survival, and the 2-year OS were 50.0% and 35.7% respectively in the group with combined surgery with radiotherapy and the group with surgery with only (P <0.05). Postoperative radiotherapy improved local control rate in stage IVA and IVB patients (P <0.05). However, surgery, radiotherapy or chemotherapy could not improve the survival of stage IVC patients. Multivariate analysis showed that distant metastases, surgery, radiotherapy and tumor residue could predict the prognosis.
  
  
  CONCLUSIONS
  Combined surgery and radiotherapy could improve overall survival in stage IVA and IVB patients. Patients with ATC have a bad prognosis. Distant metastases, surgery, radiotherapy and tumor residue are the most important factors affecting the prognosis.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Tian-Run
authors.initials: TR
authors.lastname: Liu
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Zhi-Wen
authors.initials: ZW
authors.lastname: Xiao
authors.affiliation: Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, United States of America.
authors.forename: Hai-Neng
authors.initials: HN
authors.lastname: Xu
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Long
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Fan-Qin
authors.initials: FQ
authors.lastname: Wei
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Shi-Min
authors.initials: SM
authors.lastname: Zhuang
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Xiao-Mei
authors.initials: XM
authors.lastname: Sun
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Liang-En
authors.initials: LE
authors.lastname: Xie
authors.affiliation: Department of General Surgery, Xinhua Hospital, affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China.|Institute of Biliary Tract Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Jia-Sheng
authors.initials: JS
authors.lastname: Mu
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou, China.|Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: An-Kui
authors.identifier: http://orcid.org/0000-0003-2750-9926
authors.initials: AK
authors.lastname: Yang
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Guan-Ping
authors.initials: GP
authors.lastname: Zhang
authors.affiliation: Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, United States of America.
authors.forename: Yi
authors.initials: Y
authors.lastname: Fan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D065646:Thyroid Carcinoma, Anaplastic / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*