Anaplastic thyroid carcinoma: Current diagnosis and treatment

Citation
D. Giuffrida et H. Gharib, Anaplastic thyroid carcinoma: Current diagnosis and treatment, ANN ONCOL, 11(9), 2000, pp. 1083-1089
Citations number
77
Language
INGLESE
art.tipo
Review
Categorie Soggetti
Oncology,"Onconogenesis & Cancer Research
Journal title
ANNALS OF ONCOLOGY
ISSN journal
0923-7534 → ACNP
Volume
11
Issue
9
Year of publication
2000
Pages
1083 - 1089
Database
ISI
SICI code
0923-7534(200009)11:9<1083:ATCCDA>2.0.ZU;2-3
Abstract
Background: Anaplastic thyroid carcinoma (ATC), accounting for 5% to 15% of primary malignant thyroid neoplasms, is one of the most aggressive solid t umors in humans. Generally, it is rapidly fatal, with a mean survival of si x months after diagnosis. Multimodality treatment with surgery and/or exter nal beam radiotherapy and chemotherapy are of fundamental importance for lo cal control of disease and to enhance survival. Design: We evaluated consecutive patients with ATC observed at the Mayo Cli nic from 1971 to 1993 and reviewed relevant articles published in major Eng lish-language medical journals. We used the MEDLINE database, selected bibl iographies, and articles available in our personal files. Results: ATC usually does not concentrate radioiodine or express thyroglobu lin. It is essential to verify the diagnosis histologically because insular thyroid cancer, lymphomas, and medullary thyroid cancer are occasionally c onfused with undifferentiated neoplasms. Immunohistochemical study is helpf ul in establishing the diagnosis. Multimodal therapy and the development of effective systemic chemotherapeutic agents should result in improvements i n survival, although no single agent has yet been identified. Conclusions: Aggressive multimodality treatment regimens show promise in im proving local control in patients with ATC. However, survival rates remain low. Despite intense application of such therapy, no standardized successfu l treatment protocol has been established.