Tracheal stenting has minimal impact on survival in anaplastic thyroid carcinoma.

ABSTRACT

BACKGROUND: Anaplastic 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. METHODS: The 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. RESULTS: Between 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). CONCLUSIONS: Survival 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.