TY - JOUR
T1 - Influence of risk grouping on therapeutic decisions in patients with anaplastic thyroid carcinoma
AU - Sun, Chuanzheng
AU - Li, Chao
AU - Hu, Zedong
AU - Li, Xiaojiang
AU - He, Jiehua
AU - Song, Ming
AU - Li, Guojun
AU - Zhang, Fenghua
AU - Li, Qiuli
N1 - Publisher Copyright:
© 2014, Springer-Verlag Berlin Heidelberg.
PY - 2015/4
Y1 - 2015/4
N2 - We investigated prognostic factors in 42 anaplastic thyroid carcinoma (ATC) patients from a single institution over a 30-year period and explored the use of risk grouping to guide therapeutic decisions. Univariable and multivariable differences in overall survival (OS) were evaluated using the Kaplan–Meier method and the log-rank test as well as Cox proportional hazards model. Risk grouping in making therapeutic decisions for ATC patients was explored. The 1- and 3-year OS rates were 28.6 % and 18.5 %, respectively. Univariate analysis indicated that 4 pre-therapeutic factors of patients were related to poorer prognoses: age ≥ 55 years, white blood cell count ≥ 10.0 × 109/L, blood platelet count ≥ 300.0 × 109/L and advanced clinical tumor-node-metastasis stage. These factors were used to calculate the risk indices. Patients with total risk index scores of no more than 1 were considered to be in the low-risk group, and patients with scores ≥ 2 were considered to be in the high-risk group. The patients in the low-risk group had significantly better 1- and 3-year OS rates (90.9 % and 63.6 %, respectively) than those in the high-risk group (6.5 % and 3.2 %, respectively). Risk group and therapeutic regimen were the 2 factors that independently influenced survival according to multivariable analysis. Surgery that was combined with postoperative radiotherapy significantly benefited the patients in the low-risk group rather than the patients in the high-risk group. Risk grouping was a helpful tool of evaluating the prognoses and guiding the treatment of ATC patients.
AB - We investigated prognostic factors in 42 anaplastic thyroid carcinoma (ATC) patients from a single institution over a 30-year period and explored the use of risk grouping to guide therapeutic decisions. Univariable and multivariable differences in overall survival (OS) were evaluated using the Kaplan–Meier method and the log-rank test as well as Cox proportional hazards model. Risk grouping in making therapeutic decisions for ATC patients was explored. The 1- and 3-year OS rates were 28.6 % and 18.5 %, respectively. Univariate analysis indicated that 4 pre-therapeutic factors of patients were related to poorer prognoses: age ≥ 55 years, white blood cell count ≥ 10.0 × 109/L, blood platelet count ≥ 300.0 × 109/L and advanced clinical tumor-node-metastasis stage. These factors were used to calculate the risk indices. Patients with total risk index scores of no more than 1 were considered to be in the low-risk group, and patients with scores ≥ 2 were considered to be in the high-risk group. The patients in the low-risk group had significantly better 1- and 3-year OS rates (90.9 % and 63.6 %, respectively) than those in the high-risk group (6.5 % and 3.2 %, respectively). Risk group and therapeutic regimen were the 2 factors that independently influenced survival according to multivariable analysis. Surgery that was combined with postoperative radiotherapy significantly benefited the patients in the low-risk group rather than the patients in the high-risk group. Risk grouping was a helpful tool of evaluating the prognoses and guiding the treatment of ATC patients.
KW - Anaplastic thyroid carcinoma
KW - Blood platelet count
KW - Risk grouping
KW - Therapeutic decisions
KW - White blood cell count
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U2 - 10.1007/s00405-014-2937-2
DO - 10.1007/s00405-014-2937-2
M3 - Article
C2 - 24718913
AN - SCOPUS:84897368077
SN - 0937-4477
VL - 272
SP - 985
EP - 993
JO - European Archives of Oto-Rhino-Laryngology
JF - European Archives of Oto-Rhino-Laryngology
IS - 4
ER -