Acta Medica Leopoliensia (Feb 2019)
Anaplastic thyroid carcinoma - current issues of today (according to NCCN Guidelines)
Abstract
Aim.To consider the current state of the problem of treatment patients with anaplastic thyroid carcinoma. Material and Methods. Twenty-one cases of anaplastic thyroid carcinoma were analyzed in patients from the Lviv Regional Clinical Hospital (n=9) and Lviv Regional Treatment and Diagnostical Cancer Center (n = 12) from 2004 to 2017. The approaches to treatment of anaplastic thyroid carcinoma on the basis of NCCN Guidelines over the year of 2018 are shown. Results and Discussion. Anaplastic thyroid carcinoma was more common in women - 15 cases (71,4%) than in men - 6 cases (28,6%). A diagnosis of anaplastic thyroid carcinoma was established as a result of core-biopsy in 12 (57,1%) patients; in 9 (42,9%) cases the verification was obtained after surgery. The average age of patients at the time of diagnosis was 70,9±7,5 years. Radical thyroidectomy was performed in 5 (23,8%) patients. Palliative radiation therapy was used in 3 (14,3%) patients; 4 patients had combined treatment - thyroidectomy and postoperative course of radiation therapy. Remaining 9 (42,9%) cases had symptomatic therapy; out of those, in 2 cases tracheostomy was performed due to a compression of the upper respiratory tract by the tumor. In general, there was no relationship between the type of performed treatment and the overall survival rate of the patients (р>0,05). In our study, the average of survival time was 4,2±3,9 months, and the one-year survival rate was 9,5% (n = 2). Conclusions. The results of treatment for patients with anaplastic thyroid carcinoma are currently unsatisfactory - median overall survival is only 3 months, although these data are consistent with world literature. Factors provoking this disease are not detected, and the mechanisms leading to transformation of differentiated cancer to anaplastic are not defined. All these facts require further study and clinical research.
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