Tracheal Stenting has Minimal Impact on Survival in Anaplastic Thyroid Carcinoma

• DOI: 10.1007/s00268-013-2173-8
• Publication Date: 2013-08-02T16:04:55Z
• Authors: Parameswaran Rajeev; Tarek Ezzat; Mark Slade; Gregory Paul Sadler; Radu Mihai
• Keywords: Aged, 80 and over; Male; Biopsy, Fine-Needle; Middle Aged; Thyroid Carcinoma, Anaplastic; 3. Good health; Survival Rate; Trachea; 03 medical and health sciences; 0302 clinical medicine; Thyroidectomy; Humans; Lymph Node Excision; Female; Stents; Thyroid Neoplasms; Aged; Retrospective Studies

AbstractBackgroundAnaplastic thyroid carcinoma (ATC) is the most aggressive form of thyroid cancer and it has an extremely poor prognosis. Rapid airway compromise is the main cause of death in patients with ATC.MethodsThe present study is based on a retrospective review of clinical data of patients with ATC treated over the last decade in a tertiary referral center.ResultsBetween January 1998 and December 2010, 31 patients (13 males: 18 females) with a mean age of 74 years (range: 54–90 years) had a diagnosis of ATC made on fine‐needle aspiration (n = 29) or biopsy (n = 2). Eight patients underwent total thyroidectomy and lymph node dissection, and five patients had attempted surgery but the procedure was abandoned because of inoperability. Airway compromise was clinically apparent in 11 patients. Five patients had tracheal stents inserted, with a median survival of 2 months (range: 1–36 months). In the whole cohort, 29 patients died of the disease, with a mean survival of 7 months (range: 1–36 months).ConclusionsSurvival of patients with undifferentiated thyroid cancer is severely compromised by airway obstruction. Palliation with tracheal stenting can rescue catastrophic airway obstruction but offers minimal survival benefit.