| Objective:Anaplastic thyroid cancer is a highly invasive malignant tumor with low incidence and high mortality.The current treatment methods include surgery,radiotherapy and chemotherapy,but there is no prospective study and retrospective studies exist different biases so consensus on treatment options for different populations have not yet reached.The aim of this study was to investigate the survival status and prognostic factors of patients with anaplastic thyroid cancer,explore new treatment options and develop reasonable plans based on the characteristics of the population to improve the prognosis of patients.Methods: A retrospective analysis of the clinical features and follow-up data of 88 patients with anaplastic thyroid cancer admitted to Tianjin Cancer Hospital from January 2003 to May 2016(both were newly diagnosed and pathologically diagnosed),with overall survival for the main research focus,follow-up was conducted by telephone or clinic.Prognostic factors were analyzed by Kaplan-Meier method and Cox multivariate regression.P<0.05 was statistically significant.See Pubmed for an English-language literature on anaplastic thyroid cancer,summarizing the expression of PDL-1 and the results of clinical trials.Results:The median survival time of 88 patients with anaplastic thyroid cancer was3.5 months;the 6-month survival rate was 30.7%,the 1-year survival rate was 22.7%,and the 2-year survival rate was 11.4%.IVA and IVB patients: only 33 patients(56.9%)underwent surgery,6-month survival rate was 15.2%,2-year survival rate was 3%;postoperative radiotherapy was performed in 10 patients(17.2%),and6-month survival rate was 50%.The annual survival rate was 40%;postoperative radiochemotherapy was performed in 15 patients(25.8%),the 6-month survival rate was 93.3%,and the 2-year survival rate was 86.7%.Univariate analysis showed that the maximum diameter,age,distant metastasis,lymph node metastasis,staging,white blood cell count,radiotherapy,chemotherapy,thyroid nodules,different surgical methods,and comprehensive treatment were the factors that influence the prognosis of patients with anaplastic thyroid cancer.Multivariate analysis showed that the independent factors affecting prognosis were age,stage,white blood cell count,andcomprehensive treatment.Conclusion : The prognosis of anaplastic thyroid cancer is very poor.The combination of surgical resection combined with postoperative radiotherapy and chemotherapy in young,early stage patients can prolong their survival.Even some patients who have lost their chance of surgery can still get from radiotherapy and/or chemotherapy beneficial.Molecular targeted drugs and immune checkpoint inhibitors can bring survival benefits. |
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