ECE2016 Oral Communications Thyroid Cancer (5 abstracts)
Clinical presentation, treatment and outcome of anaplastic thyroid carcinoma in Germany: a retrospective multi-center study
Julia Wendler 1 , Matthias Kroiss 1, , Katja Gast 3 , Michael Kreissl 7 , Stephanie Allelein 2 , Urs Lichtenauer 3 , Rainer Blaser 4 , Klaus Kuhn 4 , Christine Spitzweg 3 , Martin Fassnacht 1 , Dagmar Führer 5 , Matthias Schott 2 & Vera Tiedje 5
1University Hospital Würzburg, Würzburg, Germany; 2University Hospital Düsseldorf, Düsseldorf, Germany; 3Klinikum der Universität München, München, Germany; 4Technical University München, München, Germany; 5University Hospital Essen, Essen, Germany; 6Comprehensive Cancer Center, Würzburg, Germany; 7Central Hospital, Augsburg, Germany.
Context: Anaplastic (ATC) thyroid carcinoma is an orphan disease accounting for about 2% of all malignant thyroid tumors. ATC confers a dismal prognosis and standard treatment is not established.
Objective: To describe the epidemiology, current treatment regimens and outcome of ATC, to identify clinical prognostic markers and treatment factors associated with improved prognosis. To establish a consensus treatment schedule.
Design: Retrospective multicenter study.
Setting: 6 German tertiary referral centers.
Patients: 100 ATC patients diagnosed 2000 -2015
Main outcome measure: Disease specific overall survival (OS).
Results: Tumor stage was IVA in 9, IVB in 32 and IVC in 54 patients (unknown: 5). The 6-month, 1-year, 3-year, and 5-year disease specific OS rates were 37%, 28%, 18%, and 5%, respectively. Stage dependent OS at 6 months was 78%, 54% and 18% for stage IVA, B and C respectively. 29 patients survived >1 year. Multivariate analysis of OS using Cox proportional hazard regression identified age ≥70 years, incomplete local resection status and the presence of distant metastasis as significant risk factors for shorter survival. Radical surgery (hazard ratio [HR] 2.201, 95% confidence interval 1.186–4.086, P=0.012), external beam radiation (EBRT) ≥40 Gy (HR 0.339, 95%–CI 0.152–0.759, P=0.008) and any kind of chemotherapy (CTX) (HR 11.636, 95%–CI 2.424–60.394, P=0.003) were associated with longer survival in multivariate analyses adjusted for age and tumor stage. A multimodal treatment regimen applied in 49/100 patients was associated with a marginal survival benefit (HR 1.040, 1.007–1.075, P<0.0001) only in IVC patients (n=25).
Conclusion: Disease specific OS is still poor in ATC. Treatment factors associated with longer survival were identified. These were taken into account to develop a consensus treatment schedule for multimodal management of ATC.
Volume 41
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