미분화 갑상선암
Treatment of Anaplastic Thyroid Carcinoma
장항석, 윤종호, 정웅윤, 박정수,
소속 상세정보
장항석 ( Chang Hang-Seok )
연세대학교 의과대학 외과학교실
윤종호 ( Yoon Jong-Ho )
연세대학교 의과대학 외과학교실
정웅윤 ( Chung Woong-Youn )
연세대학교 의과대학 외과학교실
박정수 ( Park Cheong-Soo )
연세대학교 의과대학 외과학교실
KMID : 0371320040660010014
Abstract
Purpose: Anaplastic thyroid carcinoma (ATC) is one of the most malignant human neoplasm, with a grave prognosis. This study updates our experience with this unusual neoplasm with specific focus on the response to various treatment modalities.
Methods: Forty-seven patients with histologically proven ATC were enrolled (19 men, 28 women; mean age, 62.8 years). This group represented 1.5% of the 3,088 thyroid cancers treated between 1977 to 2002. The mean diameter of tumor was 8.8 cm (range, 2.0~20.0 cm), and 22 patients had distant metastasis (10 in the lung, 8 lung and bone, 1 brain, 1 mediastinum, and 2 lung and mediastinum). Extrathyroidal extension was seen in 26 (89.7%) of the cases that underwent surgery. Treatment modalities adopted were classified into 5 groups. Group 1, biopsy only; group 2, biopsy and chemoradiotherapy; group 3, debulking only; group 4 debulking; and chemoradiotherapy; and group 5, complete excision and chemoradiotherapy. Survival was calculated from the time of diagnosis, and comparisons of survival were done by log-rank analysis.
Results: The mean survival was 4.3 months (range, 1.0~21 months). The mean survival bases of treatment modalities were as follows: group 1 (n=10), 2.1 months (range 1.0~6.0); group 2 (n=8), 3.6 months (range, 2.0~7.0 months); group 3 (n=7), 3.0 months (range, 1.0~11.0 months); group 4 (n=14), 3.5 months (range, 2.0~9.0 months), group 5 (n=8), 9.4 months (range 5.0~21.0 months).
Conclusion: Even though a small improvement of survival in response was observed with complete excision and aggressive multimodality therapy, nearly all ATC remains ineffective to ongoing treatment modalities and continue to present a therapeutic dilemma. A more effective treatment regimen should be sought for improving the survival rate,
키워드
미분화 갑상선암;치료방법;치료결과;Anaplastic thyroid cancer;Treatment modalities;Treatment outcome
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