Analysis Of Anaplastic Thyroid Carcinoma With Differentiated Carcinoma

Objective:To analyze the patients whose pathology were anaplastic thyroid carcinoma accompanying with differentiated carcinoma,investigating the clinical manifestation and prognosis outcome,besides,exploring the possible pathogenesis and the prognostic factors of anaplastic thyroid carcinoma.Methods:retrospective study a total of 33 fully recording anaplastic thyroid carcinoma cases that complete the surgery at head and neck surgery department of Cancer Hospital,Chinese Academy of Medical Sciences from October 2006 to October 2016.Divided all patients into two groups according to whether postoperative pathology coexist of differentiated carcinoma,namely coexistence group 17 cases and common group 16 cases,the average age was 64 years old and 66.18 years old respectively.The differences of treatment,tumor,operation,comprehensive therapy and prognosis between the two groups were compared and the influence of various factors on the prognosis were analyzed.Results:The median survival time of coexistence group and common group were 6 months and 3months,but the difference was not statistically significant.For the common group,the counting of initial symptoms containing neck mass,hoarseness,dyspnea or dysphagia was 11,7,6.The mean time between onset of symptoms and treatment was 2.5 months.Preoperatively,7 patients were vocal cord fixation and 7 patients appeared with lung metastases.The counting of tumor invasion for trachea esophagus,nerves,blood vessels,muscles was 9,7,8,15.Pathology shows 2 intravascular cancer embolus.9 patients underwent radical resection,7 underwent palliative resection and 9 patients underwent comprehensive therapy.For coexistence group,the counting of initial symptoms containing neck mass,hoarseness,dyspnea or dysphagia was 12,6,4.The mean time between onset of symptoms and treatment was 2.0 months.Preoperatively,7 patients were vocal cord fixation and 5 patients appeared with lung metastases.The counting of tumor invasion for trachea esophagus,nerves,blood vessels,muscles was 9,6,9,8.Pathology shows 5 intravascular cancer embolus.8 patients underwent radical resection,9 underwent palliative resection and 7 patients underwent comprehensive therapy.With regards to all cases,univariate analysis shows that initial symptoms including the neck tumor,tumor diameter greater than 5cm,no comprehensive treatment are prognostic factors for poor prognosis.Multivariate analysis identifies that patients' self-complaints including the neck tumor was an independent risk factor for lower survival.Conclusions:The coexistence type and the common type anaplastic thyroid carcinoma share a similar clinical manifestation and prognosis.In addition,initial symptoms including neck mass,tumor diameter greater than 5cm,not using comprehensive treatment is an important influence factor for prognosis.