Endocrinol Metab.  2015 Jun;30(2):195-200. 10.3803/EnM.2015.30.2.195.

Anaplastic Thyroid Cancer: Experience of the Philippine General Hospital

• Lo TE
• Jimeno CA
• Paz-Pacheco E

• KMID: 2282010
• DOI: http://doi.org/10.3803/EnM.2015.30.2.195

Abstract

BACKGROUND
Anaplastic thyroid cancer (ATC) is a rare type of thyroid malignancy and one of the most aggressive solid tumors, responsible for between 14% and 50% of the total annual mortality associated with thyroid cancer.
METHODS
A retrospective study was made of all ATC cases diagnosed by biopsy in the Philippine General Hospital between 2008 and 2013.
RESULTS
A total of 15 patients were identified, with a median age at diagnosis of 63 years. All tumors were at least 6 cm in size upon diagnosis. All patients had a previous history of thyroid pathology, presenting with an average duration of 11 years. Eleven patients presented with cervical lymphadenopathies, whereas seven exhibited signs of distant metastases, for which the lungs appeared to be the most common site. More than 70% of the patients presented with a rapidly growing neck mass, leading to airway obstruction. Only three patients were treated using curative surgery; the majority received palliative and supportive forms of treatment. In addition, only three patients were offered radiotherapy. Chemotherapy was not offered to any patient. Only two patients were confirmed to still be alive during the study period. The median survival time for the other patients was 3 months; in the majority of cases the patient died within the first year following diagnosis.
CONCLUSION
Our experience with ATC demonstrated concordance with other institutions with respect to current clinical profile, presentation, and prognosis. An absence of distant metastases and lymph node involvement was associated with improved survival outcomes, whereas age at diagnosis and tumor size did not affect survival. Curative surgery offers the most effective means of prolonging survival. Radiotherapy and chemotherapy in combination with surgery represents a promising treatment strategy.

Keyword

Thyroid cancer, anaplastic; Philippines; Thyroid neoplasms; Thyroid; Poorly differentiated thyroid cancer

MeSH Terms

Airway Obstruction
Biopsy
Diagnosis
Drug Therapy
Hospitals, General*
Humans
Lung
Lymph Nodes
Mortality
Neck
Neoplasm Metastasis
Pathology
Philippines
Prognosis
Radiotherapy
Retrospective Studies
Thyroid Gland
Thyroid Neoplasms*

Figure

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  Fig. 1 Survival curve of Filipino patients with anaplastic thyroid cancer following diagnosis.

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  Fig. 2 Comparison of survival times following a diagnosis of anaplastic thyroid cancer.

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