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Anaplastic Thyroid Carcinoma: Biology, Pathogenesis, Prognostic Factors, and Treatment Approaches

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Abstract

Background

Anaplastic thyroid carcinoma (ATC) is one of the most aggressive solid tumors known to affect humans and carries a dismal prognosis. Our primary aim was to review its epidemiology, biology, risk factors, and prognostic indicators. We also reviewed the individual and combined roles of surgery, radiotherapy, chemotherapy, and newer therapeutic options in the management of ATC.

Methods

An extensive literature review was conducted to include all published reports on ATC. The changing trends in the management of anaplastic thyroid cancer were analyzed to summarize the current practice of management of ATC.

Results

Although ATC is rare, there has been a decline in its incidence worldwide. ATC accounts for more than half of the 1200 deaths per year attributed to thyroid cancer. Long-term survivors are rare, with >75% and 50% of patients harboring cervical nodal disease and metastatic disease, respectively, at presentation. ATC can arise de novo or from preexisting well-differentiated thyroid cancer. Surgical management has shifted from tracheostomy only for palliation to curative resection when possible. Tracheostomy is performed for impending obstruction rather than for prophylaxis. Radiotherapy has evolved from postoperative administration only to preoperative treatment, combining preoperative and postoperative treatment and using higher doses, along with hyperfractionating and accelerating dose schedules. Chemotherapy has changed from monotherapy to combination therapy, and newer drugs such as paclitaxel show promise. Similarly, novel angiogenesis-inhibiting agents are currently being used, with early reports of some benefit.

Conclusions

Despite multimodality approaches, ATC still carries a dismal prognosis. This should provoke innovative strategies beyond conventional methods to tackle this uniformly lethal disease.

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References

  1. Spires JR, Schwartz MR, Miller RH. Anaplastic thyroid carcinoma: association with differentiated thyroid cancer. Arch Otolaryngol Head Neck Surg 1988;114:40–4

    CAS  PubMed  Google Scholar 

  2. Kim JH, Leeper RD. Treatment of locally advanced thyroid carcinoma with combination doxorubicin and radiation therapy. Cancer 1987;60:2372–5

    CAS  PubMed  Google Scholar 

  3. Nel CJ, van Heerden JA, Goellner JR, et al. Anaplastic carcinoma of the thyroid: a clinicopathologic study of eighty two cases. Mayo Clin Proc 1985;60:51–8

    CAS  PubMed  Google Scholar 

  4. Venkatesh YS, Ordonez NG, Schultz PN, Hickey RC, Goepfert H, Samaan NA. Anaplastic carcinoma of the thyroid: a clinicopathologic study of 121 cases. Cancer 1990;66:321–30

    CAS  PubMed  Google Scholar 

  5. Haigh PI, Ituarte P, Wu H-S, et al. Completely resected anaplastic thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival. Cancer 2001;91:2235–42

    Article  Google Scholar 

  6. Nilsson O, Lindberg J, Zedenius J. Anaplastic giant cell carcinoma of the thyroid gland: treatment and survival over a 25 year period. World J Surg 1998;22:725–30

    Article  CAS  PubMed  Google Scholar 

  7. Lo CY, Lam KY, Wan KY. Anaplastic carcinoma of the thyroid. Am J Surg 1999;177:337–9

    Article  CAS  PubMed  Google Scholar 

  8. Tan RK, Finley RK III, Driscoll D, Bakamjian V, Hicks WL Jr, Shedd DP. Anaplastic carcinoma of the thyroid: a 24 year experience. Head Neck 1995;17:41–8

    CAS  PubMed  Google Scholar 

  9. Junor EJ, Paul J, Reed NS. Anaplastic thyroid carcinoma: 91 patients treated by surgery and radiotherapy. Eur J Surg Oncol 1992;18:83–8

    CAS  PubMed  Google Scholar 

  10. DeMeter JG, De Jong SA, Lawrence AM, Paloyan E. Anaplastic thyroid carcinoma: risk factors and outcome. Surgery 1991;110:956–63

    CAS  PubMed  Google Scholar 

  11. Kim JH, Leeper RD. Treatment of anaplastic giant and spindle cell carcinoma of the thyroid gland with combination adriamycin and radiation therapy: a new approach. Cancer 1983;52:954–7

    CAS  PubMed  Google Scholar 

  12. Aldinger KA, Samaan NA, Ibanez M, Hill CS Jr. Anaplastic carcinoma of the thyroid: a review of 84 cases of spindle and giant cell carcinoma of the thyroid. Cancer 1978;41:2267–75

    CAS  PubMed  Google Scholar 

  13. Jereb B, Stjernsward J, Lowhagen T. Anaplastic giant cell carcinoma of the thyroid: a study of treatment and prognosis. Cancer 1975;35:1293–5

    CAS  PubMed  Google Scholar 

  14. Tenvall J, Lundell G, Hallquist A, Wahlberg P, Wallin G, Tibblin S. Combined doxorubicin, hyperfractionated radiotherapy and surgery in anaplastic thyroid carcinoma: a report of two protocols. Cancer 1994;74:1348–54

    Google Scholar 

  15. Schlumberger M, Parmentier C, Delisle M-J, Couette JE, Droz JP, Sarrazin D. Combination therapy for anaplastic giant cell thyroid carcinoma. Cancer 1991;67:564–6

    CAS  PubMed  Google Scholar 

  16. Kobayashi T, Asakawa H, Umeshita K, et al. Treatment of 37 patients with anaplastic carcinoma of the thyroid. Head Neck 1996;18:36–41

    Article  CAS  PubMed  Google Scholar 

  17. Hadar T, Mor C, Shvero J, Levy R, Segal K. Anaplastic carcinoma of the thyroid. Eur J Surg Oncol 1993;19:511–6

    CAS  PubMed  Google Scholar 

  18. Goldman JM, Goren EN, Cohen MH, Webber BL, Brennan MF, Robbins J. Anaplastic thyroid carcinoma: long term survival after radical surgery. J Surg Oncol 1980;14:389–94

    CAS  PubMed  Google Scholar 

  19. Mitchell G, Huddart R, Harmer C. Phase II evaluation of high dose accelerated radiotherapy for anaplastic thyroid carcinoma. Radiother Oncol 1999;50:33–8

    Article  CAS  PubMed  Google Scholar 

  20. Simpson WJ. Anaplastic thyroid carcinoma: a new approach. Can J Surg 1980;23:25.

    CAS  PubMed  Google Scholar 

  21. Tenvall J, Tallroth E, El-Hassan A, et al. Anaplastic thyroid carcinoma: doxorubicin, hyperfractionated radiotherapy and surgery. Acta Oncol 1990;29:1025

    Google Scholar 

  22. Voutilainen PE, Multanen M, Haapiainen RK, Leppaniemi AK, Sivula AH. Anaplastic thyroid carcinoma survival. World J Surg 1999;23:975–9

    Article  CAS  PubMed  Google Scholar 

  23. Tallroth E, Wallin G, Lundell G, Lowhagen T, Einhorn J. Multimodality treatment in anaplastic giant cell thyroid carcinoma. Cancer 1987;60:1428–31

    CAS  PubMed  Google Scholar 

  24. Schaefer CJ. Long term survival in anaplastic thyroid cancer. Md Med J 1988;37:873–4

    CAS  PubMed  Google Scholar 

  25. Carcangiu ML, Steeper T, Zampi G, Rosai J. Anaplastic thyroid cancer: a study of 70 cases. Am J Clin Pathol 1983;2:135–58

    Google Scholar 

  26. Rosai J, Saxen EA, Woolner L. Undifferentiated and poorly differentiated carcinoma. Semin Diagn Pathol 1985;2:123–36

    CAS  PubMed  Google Scholar 

  27. LiVolsi VA. Surgical Pathology of the Thyroid. Philadelphia: WB Saunders, 1990: 253–74

    Google Scholar 

  28. Nusynowitz ML. Differentiating anaplastic thyroid carcinomas. J Nucl Med 1991;32:1363–4

    CAS  PubMed  Google Scholar 

  29. Agrawal S, Rao RS, Parikh EM. Histologic trends in thyroid cancer 1969-93: a clinicopathologic analysis of the relative proportion of anaplastic carcinoma of the thyroid. J Surg Oncol 1996;63:251–5

    CAS  PubMed  Google Scholar 

  30. Ain KB, Merrill JE, Philip AD. Treatment of anaplastic thyroid carcinoma with paclitaxel: phase II trial using ninety six hour infusion. Thyroid 2000;7:587–94

    Google Scholar 

  31. Sai-Ching JY, Guangpu X, Jingxuan P, Christgen M, Bamiagis A. Manumycin enhances the cytotoxic effect of paclitaxel on anaplastic thyroid carcinoma cells. Cancer Res 2000;60:650–6

    Google Scholar 

  32. Guangpu X, Jingxuan P, Martin C, Sai-Ching JY. Angiogenesis inhibition in the in vivo antineoplastic effect of manumycin and paclitaxel against anaplastic thyroid carcinoma. J Clin Endocrinol Metab 2001;86:1769–77

    Google Scholar 

  33. Jingxuan P, Guangpu X, Sai-ching JY. Cytochrome c release is upstream to activation of caspase-9, caspase-8 and caspase-3 in the enhanced apoptosis of anaplastic thyroid cancer cells induced by manumycin and paclitaxel. J Clin Endocrinol Metab 2001;86:4731–40

    Google Scholar 

  34. Rouslan K, Jaroslav C, Alexandra AK, et al. Selective activity of BS-RNase against anaplastic thyroid cancer. Anticancer Res 2001;21:1035–42

    CAS  PubMed  Google Scholar 

  35. Franzen A, Heldin NE. BMP-7-induced cell cycle arrest of anaplastic thyroid carcinoma cells via p21 and p27. Biochem Biophys Res Commun 2001;285:773–81

    Article  CAS  PubMed  Google Scholar 

  36. Blagosklonny MV, Paraskevi G, Malgorzata W, et al. Effects of p53 expressing adenovirus on the chemosensitivity and differentiation of anaplastic thyroid cancer cells. J Clin Endocrinol Metab 2001;83:2516–22

    Google Scholar 

  37. Yuji N, Haruhiko Y, Katuso TL. Adenovirus mediated tumour suppressor p53 gene therapy for anaplastic thyroid carcinoma in vitro and in vivo. J Clin Endocrinol Metab 2000;85:4081–6

    Google Scholar 

  38. Franceschi S, Boyle P, Maionneuve P, et al. The epidemiology of thyroid carcinoma. Crit Rev Oncog 1993;4:25–52

    CAS  PubMed  Google Scholar 

  39. Reeve TS, Delbridge L. Thyroid cancers of follicular origin. Prog Surg 1988;19:78–88

    Google Scholar 

  40. De Groot LJ, Kaplan EL, McCormick M, Straus FH. Natural history, treatment and course of papillary thyroid carcinoma. J Clin Endocrinol Metab 1990;71:414–24

    Google Scholar 

  41. Saman NA, Schultz PN, Hickey RC, et al. The results of various modalities of treatment of well-differentiated thyroid carcinomas: a retrospective review of 1599 patients. J Clin Endocrinol Metab 1992;75:714–20

    Google Scholar 

  42. Gilliland FD, Hunt WC, Morris DM, Key CR. Prognostic factors for thyroid carcinoma. A population based study of 15,698 cases from the Surveillance, Epidemiology and End Results (SEER) program 1973–91. Cancer 1997;79:564–73

    Article  CAS  PubMed  Google Scholar 

  43. Landis SH, Murray T, Bolden S, Wingo PA. Cancer statistics, 1998. CA Cancer J Clin 1998;48:6–29

    CAS  PubMed  Google Scholar 

  44. Ain KB. Anaplastic thyroid carcinoma: a therapeutic challenge. Semin Surg Oncol 1999;16:64–9

    Article  CAS  PubMed  Google Scholar 

  45. Ain KB. Anaplastic thyroid carcinoma: behaviour, biology and therapeutic approaches. Thyroid 1998;8:715–26

    CAS  PubMed  Google Scholar 

  46. Cady B, Rossi RL. Undifferentiated carcinoma and lymphoma of thyroid gland. In: Cady B, Rossi RL, eds. Surgery of the Thyroid and Parathyroid Glands. Philadelphia: WB Saunders, 1991:179–86

    Google Scholar 

  47. Lampertico P. Anaplastic (sarcomatoid) carcinoma of the thyroid gland. Semin Diagn Pathol 1993;10:159–68

    CAS  PubMed  Google Scholar 

  48. Ezaki H, Ebihara S, Fujimoto Y, et al. Analysis of thyroid carcinoma based on material registered in Japan during 1977-1986 with special reference to predominance of papillary type. Cancer 1991;70:808.

    CAS  PubMed  Google Scholar 

  49. Myskow MW, Krajewski AS, Dewar AE, Millar EP, McLaren K, Fabre JW. The role of immunoperoxidase techniques on paraffin embedded tissue in determining the histogenesis of undifferentiated thyroid neoplasms. Clin Endocrinol 1986;24:335–41

    CAS  Google Scholar 

  50. Tobler A, Maurer R, Hedinger CE. Undifferentiated thyroid tumors of diffuse small cell type. Histological and immunohistochemical evidence for their lymphomatous nature. Virchows Arch A Pathol Anat Histopathol 1984;404:117–26

    Article  CAS  PubMed  Google Scholar 

  51. Holting T, Moller P, Tschahargane C, Meybier H, Buhr H, Herfarth C. Immunohistochemical reclassification of anaplastic carcinoma reveals small and giant cell lymphoma. World J Surg 1990;14:291–5

    CAS  PubMed  Google Scholar 

  52. McIver B, Hay ID, Giuffrida D, et al. Anaplastic thyroid carcinoma: a 50 year experience at a single institution. Surgery 2001;130:1028–34

    Article  CAS  PubMed  Google Scholar 

  53. Nishiyama RH, Dunn EL, Thompson NW. Anaplastic spindle-cell and giant cell tumours of the thyroid gland. Cancer 1972;30:113–27

    CAS  PubMed  Google Scholar 

  54. Bakiri F, Djemli FK, Mokrane LA, Djidel FK. The relative roles of endemic goiter and socio economic development status in the prognosis of thyroid carcinoma. Cancer 1998;82:1146–53

    Article  CAS  PubMed  Google Scholar 

  55. Carty SE. Anaplastic thyroid cancer. In: Doherty G, Skogeid B, eds. Surgical Endocrinology. Philadelphia: Lippincott Williams & Wilkins, 2001:127–34

    Google Scholar 

  56. Giuffrida D, Gharib D. Anaplastic thyroid carcinoma: current diagnosis and treatment. Ann Oncol 2000;11:1083–9

    CAS  PubMed  Google Scholar 

  57. Besic N, Auersperg M, Us-Krasovec M, Golouh R, Frkovic-Grazio S, Vodnik A. Effects of primary treatment on survival in anaplastic thyroid carcinoma. Eur J Surg Oncol 2001;27:260–4

    Article  CAS  PubMed  Google Scholar 

  58. Murabe H, Akamizu T, Kubota A, Kusaka S. Anaplastic thyroid carcinoma with prominent cardiac metastasis, accompanied by a marked leucocytosis with a neutrophilia and high GM-CSF level in serum. Int Med 1992;31:1107–11

    CAS  Google Scholar 

  59. Lip GY, Jaap AJ, McCruden DC. A presentation of anaplastic carcinoma of the thyroid with symptomatic intra abdominal metastasis. Br J Clin Pract 1992;46:143–4.

    CAS  PubMed  Google Scholar 

  60. Llyod RV. Thyroid. In: Lloyd RV, ed. Endocrine Physiology. New York: Springer-Verlag, 1990: 37–70

    Google Scholar 

  61. Basolo F, Pollina L, Fontanini G, Fiore L, Pacini F, Baldanzi A. Apoptosis and proliferation in thyroid carcinoma: correlation with bcl-2 and p53 protein expression. Br J Cancer 1997;75:537–41

    CAS  PubMed  Google Scholar 

  62. Wolf BC, Sheahan K, DeCoste D, Variakojis D, Alpern HD, Haselow RE. Immunohistochemical analysis of small cell tumours of the thyroid gland. An Eastern Cooperative Oncology Group study. Hum Pathol 1992;23:1252–61

    Article  CAS  PubMed  Google Scholar 

  63. Pasieka J. Anaplastic thyroid cancer. Curr Opin Oncol 2003;15:78–83

    Article  PubMed  Google Scholar 

  64. Ordonez NG, El-Naggar AK, Hickey RC, et al. Anaplastic thyroid carcinoma: immunocytochemical study of 32 cases. Am J Clin Pathol 1991;1:15–24

    Google Scholar 

  65. LiVolsi VA, Brooks JJ, Arendash-Durand B. Anaplastic thyroid tumours: immunohistology. Am J Clin Pathol 1987;87:434–42

    CAS  PubMed  Google Scholar 

  66. Shvero J, Gal R, Avidor I, Hadar T, Kessler E. Anaplastic thyroid carcinoma: a clinical, histologic and immunohistochemical study. Cancer 1988;62:319–25

    CAS  PubMed  Google Scholar 

  67. Austin JR, El-Naggar AK, Goepfort H. Thyroid cancers II: medullary, anaplastic, lymphoma, sarcoma, squamous cell. Otolaryngol Clin North Am 1996;29:611–27

    CAS  PubMed  Google Scholar 

  68. Carcangiu ML, Zampi G, Roasi J. Poorly differentiated (“insular”) thyroid carcinoma. A reinterpretation of Langhans’ “wuchernde struma.” Am J Surg Pathol 1984;8:655–68

    CAS  PubMed  Google Scholar 

  69. Lam KY, Lo CY, Chan KW, Wan KY. Insular and anaplastic thyroid carcinoma of the thyroid: a 45 year comparative study at a single institution and a review of the significance of p53 and p21. Ann Surg 2000;231:329–38

    Article  CAS  PubMed  Google Scholar 

  70. Ito T, Seyama T, Mizuno T, et al. Genetic alterations in thyroid tumour progression: association with p53 gene mutations. Jpn J Cancer Res 1993;84:526–31

    CAS  PubMed  Google Scholar 

  71. Ito T, Seyama T, Mizuno T, et al. Unique association of p53 mutations with undifferentiated but not with differentiated carcinomas of the thyroid gland. Cancer Res 1992;52:1369–71

    CAS  PubMed  Google Scholar 

  72. Harada T, Shimaoka K, Katagiri M, Shimizu M, Hosoda Y, Ito K. Rarity of squamous cell carcinoma of the thyroid: autopsy review. World J Surg 1994;18:542–6

    Article  CAS  PubMed  Google Scholar 

  73. Fagin JA. Molecular genetics of human thyroid neoplasms. Annu Rev Med 1994;45:45–52

    CAS  PubMed  Google Scholar 

  74. Passler C, Scheuba C, Prager G, et al. Anaplastic (undifferentiated thyroid carcinoma (ATC). Langenbecks Arch Surg 1999;384:284–93

    Article  CAS  PubMed  Google Scholar 

  75. Wallin G, Backdahl M, Tallroth-Ekman E, Lundell G, Auer G, Lowhagen T. Co-existent anaplastic and well differentiated thyroid carcinomas: a nuclear DNA study. Eur J Surg Oncol 1989;15:43–8

    CAS  PubMed  Google Scholar 

  76. Bronner MP, LiVolsi VA. Spindle cell squamous carcinoma of the thyroid: an unusual anaplastic carcinoma associated with tall cell papillary cancer. Mod Pathol 1991;4:637–43

    CAS  PubMed  Google Scholar 

  77. Sugitani I, Kasai N, Fujimoto Y, Yanagisawa A. Prognostic factors and therapeutic strategies for anaplastic carcinoma of the thyroid. World J Surg 2001;25:617–22

    Article  CAS  PubMed  Google Scholar 

  78. Lu WT, Lin JD, Huang HS, et al. Does surgery improve the survival of patients with anaplastic carcinoma of the thyroid. Otolaryngol Head Neck Surg 1998;118:728–31

    Article  CAS  PubMed  Google Scholar 

  79. Lo C, Kam K, Wan K. Anaplastic carcinoma of the thyroid. Am J Surg 1999;23:337–9

    Google Scholar 

  80. Rodriguez JM, Pinero A, Ortiz S, et al. Clinical and histological differences in anaplastic thyroid carcinoma. Eur J Surg 2000;166:34–8

    CAS  PubMed  Google Scholar 

  81. Saunders CA, Nayar R. Anaplastic spindle-cell squamous carcinoma arising in association with tall cell papillary cancer of the thyroid: a potential pitfall. Diagn Cytopathol 1999;21:413–8

    Article  CAS  PubMed  Google Scholar 

  82. Moreno A, Rodriguez JM, Sola JL. Prognostic value of tall cell variety of papillary cancer of the thyroid. Eur J Surg Oncol 1993;19:517–21

    Google Scholar 

  83. Ibanez ML, Russell WO, Albores-Saavedra J, Lampertico P, White EC, Clark RL. Thyroid carcinoma—biologic behaviour and mortality: post mortem findings in 42 cases including 27 in which the disease was fatal. Cancer 1996;19:1039–52

    Google Scholar 

  84. Steels E, Paesmans M, Befghmans T, et al. Role of p53 as a prognostic factor for survival in lung cancer: a systematic review of the literature with meta analysis. Eur Respir J 2001;18:705–19

    Article  CAS  PubMed  Google Scholar 

  85. Campo E, de la Calle Martin O, Miquel R, et al. Loss of heterozygosity of p53 gene and p53 protein expression in human colorectal carcinomas. Cancer Res 1991;51:5536–42

    Google Scholar 

  86. Marks JR, Humphrey PA, Wu K, et al. Overexpression of p53 and HER-2/neu proteins as prognostic markers in early stage breast cancer. Ann Surg 1994;219:332–41

    CAS  PubMed  Google Scholar 

  87. Moretti F, Farsetti A, Soddu S, et al. p53 re expression inhibits proliferation and restores differentiation of human thyroid anaplastic carcinoma cells. Oncogene 1997;14:729–40

    Article  CAS  PubMed  Google Scholar 

  88. Zou M, Shi Y, Farid NR. p53 mutations in all stages of thyroid carcinomas. J Clin Endocrinol Metab 1993;77:1054–8

    Article  CAS  PubMed  Google Scholar 

  89. Weisman SM, Loree TR, Rigual NR, et al. Anaplastic transformation of thyroid cancer; review of clinical, pathologic and molecular evidence provides new insights into disease biology and future therapy. Head Neck 2003; 25:662–70

    Google Scholar 

  90. Stoler DL, Datta RV, Charles MA, et al. Genomic instability measurement in the diagnosis of thyroid neoplasms. Head Neck 2002;24:290–5

    Article  PubMed  Google Scholar 

  91. Fagin JA, Tang SH, Zeki K, Di Lauro R, Fusco A, Gonsky R. Re expression of thyroid peroxidase in a derivative of an undifferentiated thyroid carcinoma cell line by introduction of wild type p53. Cancer Res 1996;56:765–71

    CAS  PubMed  Google Scholar 

  92. Galer Davidson H, Bibbo M, Dytch HE, Gonzalez-Campora R, Fernandez A, Wied GL. Nuclear DNA in anaplastic thyroid carcinoma with a differentiated component. Histopathology 1987;11:715–22

    Google Scholar 

  93. Us-Krasovec M, Golouh R, Auersperg M. Anaplastic carcinoma in fine needle aspirates. Acta Cytol 1996;40:953–8

    CAS  PubMed  Google Scholar 

  94. Pacheco-Ojeda L, Martinez A, Alvarez M. Anaplastic thyroid carcinoma in Ecuador: analysis of prognostic factors. Int Surg 2000;86:117–21

    Google Scholar 

  95. Sugino K, Ito K, Mimura T, et al. The important role of operations in the management of anaplastic thyroid carcinoma. Surgery 2002;131:245–8

    Article  PubMed  Google Scholar 

  96. Cobin RH, Gharib H, Bergman DAL. AACE/AAES medical/surgical guidelines for clinical practice: management of throid cancer. Endocr Pract 2001;7:203–20

    Google Scholar 

  97. Hotling T, Meybier H, Buhr H. Status of tracheotomy in treatment of the respiratory emergency in anaplastic thyroid cancer (in German). Wien Klin Wochenschr 1990;102:264–6

    Google Scholar 

  98. Levendag PC, De Porre PM, van Putten WL. Anaplastic carcinoma of the thyroid gland treated by radiation therapy. Int J Radiat Oncol Biol Phys 1993;26:125–8.

    CAS  PubMed  Google Scholar 

  99. Tenvall J, Lundell G, Wahlberg P, et al. Anaplastic thyroid carcinoma: three protocols combining doxorubicin, hyperfractionated radiotherapy and surgery. Br J Cancer 2002;86:1848–53

    Google Scholar 

  100. Wong CS, Can Dyk K, Simpson WJ. Myelopathy following hyperfractionated accelerated radiotherapy for anaplastic thyroid carcinoma. Radiother Oncol 1991;20:3–9

    Article  CAS  PubMed  Google Scholar 

  101. Kim JH, Leeper RD. Treatment of locally advanced thyroid carcinoma with combination doxorubicin and radiation therapy. Cancer 1987;60:2372–5

    CAS  PubMed  Google Scholar 

  102. Poster DS, Bruno S, Penta J, Pina K, Catane R. Current status of chemotherapy in the treatment of advanced carcinoma of the thyroid gland. Cancer Clin Trials 1981;4:301–7

    CAS  PubMed  Google Scholar 

  103. Shimaoka K, Schoenffeld DA, DeWys WD, Creech RH, DeConti R. A randomized trial of doxorubicin versus doxorubicin plus cisplatin in patients with advanced thyroid carcinoma. Cancer 1985;56:2155–60

    CAS  PubMed  Google Scholar 

  104. Williams SD, Birch R, Einhorn LH. Phase II evaluation of doxorubicin plus cisplatin in advanced thyroid cancer: a Southeastern Cancer Study Group trial. Cancer Treat Rep 1986;70:405–7

    CAS  PubMed  Google Scholar 

  105. Asakawa H, Koboyashi T, Komoije Y, et al. Chemosensitivity of anaplastic thyroid carcinoma and poorly differentiated thyroid carcinoma. Anticancer Res 1997;17:2757–62

    CAS  PubMed  Google Scholar 

  106. De Besi P, Busnardo B, Toso S, et al. Combined chemotherapy with bleomycin, adriamycin and platinum in advanced thyroid carcinoma. J Endocrinol Invest 1991;14:475–80

    PubMed  Google Scholar 

  107. Sokal M, Harmer CL. Chemotherapy for anaplastic carcinoma of the thyroid. Clin Oncol 1978;4:3–10

    CAS  PubMed  Google Scholar 

  108. Gottlieb JA, Hill CS Jr, Ibanez ML, Clark RL. Chemotherapy of thyroid cancer. An evaluation of experience with 37 patients. Cancer 1972;30:848–53

    CAS  PubMed  Google Scholar 

  109. Gottlieb JA, Hill CS Jr. Chemotherapy of thyroid cancer with Adriamycin. Experience with 30 patients. N Engl J Med 1974;290:193–7

    CAS  PubMed  Google Scholar 

  110. Ahuja S, Ernst H. Chemotherapy of thyroid carcinoma. J Endocrinol Invest 1987;10:303–10

    CAS  PubMed  Google Scholar 

  111. Bukowski RM, Brown L, Weick JK, Groppe CW, Purvis J. Combination chemotherapy of metastatic thyroid cancer: phase II study. Am J Clin Oncol 1983;6:579–81

    CAS  PubMed  Google Scholar 

  112. Satake S, Suguwara I, Watanabe M, Takami H. Lack of point mutation of human DNA topoisomerase II in multidrug-resistant anaplastic thyroid carcinoma cell lines. Cancer 1997;116:33–9

    CAS  Google Scholar 

  113. Lenhert M. Clinical multi drug resistance in cancer: a multifactorial problem. Eur J Cancer 1996;32:912–20

    Google Scholar 

  114. Mancusi F, Giardina S, Elise IR. Anaplastic thyroid carcinoma: retrospective analysis of 34 patients treated with external radiotherapy (R), chemotherapy (C), or both (R + C). J Endocrinol Invest 1993;16:100.

    Google Scholar 

  115. Werner B, Abele J, Alveryd A, et al. Multimodality therapy in anaplastic giant cell thyroid carcinoma. World J Surg 1984;8:64–70

    Article  CAS  PubMed  Google Scholar 

  116. Pacini F, Vitti P, Martino E. Treatment of refractory thyroid cancer with adriamycin. Drugs Exp Clin Res 1984;10:911–5

    Google Scholar 

  117. Tallroth E, Wallin G, Lundell G, Lowhagen T, Einhorn J. Multimodality treatment in anaplastic giant cell thyroid carcinoma. Cancer 1987;60:1428–31

    CAS  PubMed  Google Scholar 

  118. Auersperg M, Us-Krasovec M, Petric G, Pogacnik A, Besic N. Results of combined modality treatment in poorly differentiated and anaplastic thyroid carcinoma. Wien Klin Wochenschr 1990;102:267–70

    CAS  PubMed  Google Scholar 

  119. Chemotherapy Committee, the Japanese Society of Thyroid Surgery. Intensive chemotherapy for anaplastic thyroid carcinoma: combination of cisplatin, doxorubicin, etoposide and peplomycin with granulocyte colony-stimulating factor support. Jpn J Clin Oncol 1995;25:203–7

    Google Scholar 

  120. Biganzoli L, Gebbia V, Maiorino L, Caraci P, Iirillo A. Different outcomes to chemotherapy according to tumour histology. Eur J Cancer 1995;31:2423–4

    Article  Google Scholar 

  121. Sekiguchi M, Shiroko Y, Arai T, et al. Biological characteristics and chemosensitivity profile of four human anaplastic thyroid carcinoma cell lines. Biomed Pharmacother 2001;55:466–74

    Article  CAS  PubMed  Google Scholar 

  122. Dowlati A, Robertson C, Cooney M, et al. A phase I pharmacokinetic and translational study of the novel vascular targeting agent combretastatin a-4 phosphate on a single dose intravenous schedule in patients with advanced cancer. Cancer Res 2002;15:3408–16

    Google Scholar 

  123. Randal J. Antiangiogenesis drugs target specific cancers, mechanisms. J Natl Cancer Inst 2000;92:520–2

    CAS  PubMed  Google Scholar 

  124. Dziba JM, Marcinek R, Venkataraman GM, Robinson JA, Ain KB. Combretastatin A4 phosphate has primary antineoplastic activity against human anaplastic thyroid carcinoma cell lines and xenograft tumours. Thyroid 2002;12:1063–70

    Article  CAS  PubMed  Google Scholar 

  125. Venkataraman GM, Yatin M, Marcinek R, Ain KB. Restoration of iodine uptake in dedifferentiated thyroid carcinoma: relationship to human Na +/I- symported gene methylation status. J Clin Endocrinol Metab 1999;84:2449–57.

    Article  CAS  PubMed  Google Scholar 

  126. Spitzweg C, Harrington KJ, Pinke LA, Vile RG, Morris JC. The sodium iodide symporter and its potential in cancer therapy. J Clin Endocrinol Metab 2001;86:3327–35

    Article  CAS  PubMed  Google Scholar 

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  1. Department of Surgical Oncology, Memorial Sloan-Kettering Cancer Center, 1233 York Avenue, 16 I, New York, New York, 10021

    Chandrakanth Are MD

  2. Department of Head and Neck Surgery, Memorial Sloan-Kettering Cancer Center, 1233 York Avenue, 16 I, New York, New York, 10021

    Ashok R. Shaha MD

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Are, C., Shaha, A.R. Anaplastic Thyroid Carcinoma: Biology, Pathogenesis, Prognostic Factors, and Treatment Approaches. Ann Surg Oncol 13, 453–464 (2006). https://doi.org/10.1245/ASO.2006.05.042

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