The review article by Pavlidis et al published in World J Clin Oncol provides a meticulous analysis of the intricacies surrounding anaplastic carcinoma of the thyroid.Thyroid carcinoma encompasses a spectrum of diseas...The review article by Pavlidis et al published in World J Clin Oncol provides a meticulous analysis of the intricacies surrounding anaplastic carcinoma of the thyroid.Thyroid carcinoma encompasses a spectrum of diseases,each charac-terized by distinct behaviors and outcomes.Diagnostic approaches encompass a diverse array of tools.Surgery remains the pivotal treatment for anaplastic thyroid carcinoma.Radiotherapy and chemotherapy offer the best overall sur-vival in aggressive disease.Combinations of immunotherapy with targeted the-rapies,such as dabrafenib-trametinib,demonstrate potential for enhanced effect-iveness and improved survival outcomes.Multifaceted approach fuelled by precision medicine and interdisciplinary collaboration is imperative in charting a course toward improved outcomes in this formidable malignancy.展开更多
Thyroid carcinoma is a complex disease with several types,the most common being well-differentiated and undifferentiated.The latter,“undifferentiated carcinoma”,also known as anaplastic thyroid carcinoma(ATC),is a h...Thyroid carcinoma is a complex disease with several types,the most common being well-differentiated and undifferentiated.The latter,“undifferentiated carcinoma”,also known as anaplastic thyroid carcinoma(ATC),is a highly aggr-essive malignant tumor accounting for less than 0.2%of all thyroid carcinomas and carries a poor prognosis with a median survival of 5 months.BRAF gene mutations are the most common molecular factor associated with this type of thyroid carcinoma.Recent advances in targeted biological agents,immuno-therapy,stem cell therapy,nanotechnology,the dabrafenib/trametinib com-bination therapy,immune checkpoint inhibitors(ICI)and artificial intelligence offer novel treatment options.The combination therapy of dabrafenib and tra-metinib is the current standard treatment for patients with BRAF-V600E gene mutations.Besides,the dabrafenib/trametinib combination therapy,ICI,used alone or in combination with targeted therapies have raised some hopes for improving the prognosis of this deadly disease.Younger age,earlier tumor stage and radiotherapy are all prognostic factors for improved outcomes.Ultimately,therapeutic regimens should be tailored to the individual patient based on surveillance and epidemiological data,and a multidisciplinary approach is ess-ential.展开更多
Background: Anaplastic thyroid cancer (ATC), while rare, carries a uniformly poor prognosis. Current treatment includes surgery when possible, radiotherapy, and chemotherapy. Multiple chemotherapeutic agents are in th...Background: Anaplastic thyroid cancer (ATC), while rare, carries a uniformly poor prognosis. Current treatment includes surgery when possible, radiotherapy, and chemotherapy. Multiple chemotherapeutic agents are in the process of clinical testing, and promising agents include those in the tyrosine kinase inhibitor family. Our patient represents a novel case of ATC treated with sunitinib, one such tyrosine kinase inhibitor. Methods/Results: We utilized the experimental sunitinib in conjunction with radiation therapy to treat a patient with aggressive ATC in whom curative resection was unable to be achieved due to carotid sheath and tracheal involvement. The patient had marked clinical response and sustained stable disease for 8 months, which coincides with reported data regarding sunitinib to treat other thyroid malignancies. Conclusion: Our case illustrates the efficacy of sunitinib therapy as a possible adjunct in the treatment of ATC.展开更多
Anaplastic thyroid carcinoma(ATC)is the rarest,but deadliest histologic type among thyroid malignancies,with a dismal median survival of 3-9 mo.Even though ATC accounts for less than 2%of all thyroid tumors,it is resp...Anaplastic thyroid carcinoma(ATC)is the rarest,but deadliest histologic type among thyroid malignancies,with a dismal median survival of 3-9 mo.Even though ATC accounts for less than 2%of all thyroid tumors,it is responsible for 14%-39%of thyroid carcinoma-related deaths.ATC clinically presents as a rapidly growing mass in the neck,associated with dyspnoea,dysphagia and vocal cord paralysis.It is usually locally advanced and often metastatic at initial presentation.For operable diseases,the combination of radical surgery with adjuvant radiotherapy or chemotherapy,using agents such as doxorubicin and cisplatin,is the best treatment strategy.Cytotoxic drugs for advanced/metastatic ATC are poorly effective.On the other hand,targeted agents might represent a viable therapeutic option.Axitinib,combretastatin A4,sorafenib and imatinib have been tested in small clinical trials of ATC,with a promising disease control rate ranging from 33%to 75%.Other clinical trials of targeted therapy for thyroid carcinoma are currently ongoing.Biological agents that are under investigation include pazopanib,gefitinib and everolimus.With the very limited therapeutic armamentarium available at the present time,targeted therapy constitutes an exciting new horizon for ATC.In future,biological agents will probably represent the standard of care for this aggressive malignancy,in the same fashion as it has recently occurred for other chemo-refractory tumors,such as kidney and hepatic cancer.展开更多
The prognosis of small cell thyroid carcinoma(SCTC)in a large cohort has not been well reported in the literature.In this study,we analyzed the mortality of SCTC,in comparison to medullary thyroid cancer(MTC)and anapl...The prognosis of small cell thyroid carcinoma(SCTC)in a large cohort has not been well reported in the literature.In this study,we analyzed the mortality of SCTC,in comparison to medullary thyroid cancer(MTC)and anaplastic thyroid cancer(ATC),based on the Surveillance,Epidemiology,and End Results(SEER)Program of the National Cancer Institute,to determine the prognosis of SCTC.Information regarding patients with a diagnosis of MTC,ATC,or SCTC,between 2004 and 2013,was acquired from the SEER database.Patient survival curves were assessed by Cox proportional hazards regression analyses,Kaplan-Meier analyses,and log-rank tests.In a Kaplan-Meier analysis of the entire cohort of thyroid cancer patients,cancer-specific survival declined sharply for patients with SCTC,but it declined more modestly for patients with MTC.The cancer-specific survival was not significantly different between SCTC and ATC.Unadjusted Cox regression analysis showed that SCTC had a higher cancer-specific mortality than MTC but a similar prognosis as ATC.SCTC showed a higher cancer-specific mortality than MTC and ATC after adjustments for various confounding factors.SCTC was found to have a more highly lethal clinical course than MTC and had a similar death rate to ATC.Therefore,we recommend that aggressive,radical treatment like surgery or radiation should be performed tor these patients.展开更多
Well-differentiated thyroid carcinoma has a favorable prognosis with a 5-year survival rate of over 95%.However,the undifferentiated or anaplastic type accounting for<0.2%,usually in elderly individuals,exhibits a ...Well-differentiated thyroid carcinoma has a favorable prognosis with a 5-year survival rate of over 95%.However,the undifferentiated or anaplastic type accounting for<0.2%,usually in elderly individuals,exhibits a dismal prognosis with rapid growth and disappointing outcomes.It is the most aggressive form of thyroid carcinoma,with a median survival of 5 mo and poor quality of life(airway obstruction,dysphagia,hoarseness,persistent pain).Early diagnosis and staging are crucial.Diagnostic tools include biopsy(fine needle aspiration,core needle,open surgery),high-resolution ultrasound,computed tomography,magnetic resonance imaging,[(18)F]fluoro-D-glucose positron emission tomography/computed tomography,liquid biopsy and microRNAs.The BRAF gene(BRAF-V600E and BRAF wild type)is the most often found molecular factor.Others include the genes RET,KRAS,HRAS,and NRAS.Recent management policy is based on surgery,even debulking,chemotherapy(cisplatin or doxorubicin),radiotherapy(adjuvant or definitive),targeted biological agents and immunotherapy.The last two options constitute novel hopeful management modalities improving the overall survival in these otherwise condemned patients.Anti-programmed death-ligand 1 antibody immunotherapy,stem cell targeted therapies,nanotechnology achievements and artificial intelligence implementation provide novel promising alternatives.Genetic mutations determine molecular pathways,thus indicating novel treatment strategies such as anti-BRAF,anti-vascular endothelial growth factor-A,and anti-epidermal growth factor receptor.Treatment with the combination of the BRAF inhibitor dabrafenib and the MEK inhibitor trametinib has been approved by the Food and Drug Administration in cases with BRAF-V600E gene mutations and is currently the standard care.This neoadjuvant treatment followed by surgery ensures a twoyear overall survival of 80%.Prognostic factors for improved outcomes have been found to be younger age,earlier tumor stage and radiation therapy.A multidisciplinary approach is necessary,and the therapeutic plan should be individu alized based on surveillance and epidemiology end results.展开更多
Anaplastic thyroid carcinoma (ATC) is a poorly differentiated thyroid cancer. It cannot uptake iodine or synthesis thyroglobulin. The incidence is low;about 2% - 5% of thyroid cancer. The peak age incidence is 60 - 70...Anaplastic thyroid carcinoma (ATC) is a poorly differentiated thyroid cancer. It cannot uptake iodine or synthesis thyroglobulin. The incidence is low;about 2% - 5% of thyroid cancer. The peak age incidence is 60 - 70 years and it is more common in females (55% - 77% of all patients). In recent years, the incidence has declined;however, it may be higher in areas of endemic goiter. ATC may occur with a coexisting carcinoma and may represent transformation of a well-differentiated thyroid cancer. Patients typically present with a rapidly growing anterior neck mass and aggressive symptoms. The most reliable tool in detecting thyroid malignancies is fine-needle aspiration cytology (FNAC). Sensitivity of FNAC for thyroid malignancy ranged from 61% to 97.7%. Fine-needle aspiration can diagnose ATC by the demonstration of spindled or giant cells, bizarre neoplastic cells that may be multinucleated, or atypical cells with high mitotic activity. A syncytial pattern is the predominant cellular pattern of anaplastic thyroid carcinoma. Other laboratory tests, including tumor markers (cytokeratin, vimentin, and carcinoembryogenic antigen) are helpful in diagnosis and follow-up of the patients. Multimodality therapy (surgery, external beam radiation, and chemotherapy) is the recommended treatment and it seems to have slightly improved outcomes. The prognosis is not as bad in younger patients with smaller tumors. The most common cause of death is lung metastasis. The mean survival time is less than 6 months from the time of diagnosis. The prompt diagnosis and aggressive treatment are essential modality to achieve optimal outcomes.展开更多
Anaplastic thyroid cancer is an uncommon malignancy with a poor prognosis. Elderly patients are most commonly afflicted and survival past 3 years occurs in less than 5% of patients. Management of these patients is cha...Anaplastic thyroid cancer is an uncommon malignancy with a poor prognosis. Elderly patients are most commonly afflicted and survival past 3 years occurs in less than 5% of patients. Management of these patients is challenging, and the importance of palliation, airway protection, and aggressive resection is debated. In this report, we describe a patient with anaplastic thyroid carcinoma who presented with respiratory distress due to invasion of the tracheal cartilage. The patient was managed with cricotracheal resection, total thyroidectomy and thyrotracheal anastomosis. The patient is currently disease free 3.5 years after resection and postoperative radiation therapy with interval neck dissection.展开更多
Background and objective: Thyroid cancer is the most common endocrine malignancy. This report aims to describe the pattern of thyroid cancer presentations at King Abdulaziz University Hospital, Jeddah. Methods: This w...Background and objective: Thyroid cancer is the most common endocrine malignancy. This report aims to describe the pattern of thyroid cancer presentations at King Abdulaziz University Hospital, Jeddah. Methods: This was a retrospect chart review of all thyroid cancer cases diagnosed between 2001 and 2010 at King Abdulaziz University Hospital, Jeddah. We documented patients’ demographic and clinical data, including age at diagnosis, tumor type and size, extrathyroidal extension, and metastasis. Results: A total of 114 thyroid cancer cases were diagnosed from 2001 through 2010. Females comprise the majority of cases (female to male ratio of 4:1). The mean ages of patients diagnosed with different thyroid cancers were: papillary thyroid cancer, 39.6 years;follicular thyroid cancer, 43.2 years;medullary thyroid cancer, 55.8 years;and anaplastic thyroid cancer, 46.0 years. Papillary thyroid cancer was diagnosed in 88 cases (77%), follicular thyroid cancer in 19 cases (17%), medullary thyroid cancer in 5 cases (4%), and anaplastic thyroid cancer in 2 cases (2%). Conclusion: Thyroid cancers are more common among females. The disease is diagnosed at a relatively young age among our patients (40 years). Papillary thyroid cancer is the most common type of thyroid cancer.展开更多
Objective:To provide an understanding of the incidence of anaplastic thyroid cancer within the United States.Methods:Patients in the Surveillance,Epidemiology,and End Results (SEER) database were included from 1973 to...Objective:To provide an understanding of the incidence of anaplastic thyroid cancer within the United States.Methods:Patients in the Surveillance,Epidemiology,and End Results (SEER) database were included from 1973 to 2014 based on a diagnosis of anaplastic thyroid cancer using ICDO-3 codes.Patients were categorized into cohorts based on their year of diagnosis.Results:1527 patients were diagnosed with anaplastic thyroid cancer within the SEER 18 registries.The age-adjusted incidence rate was 0.2 per 1,000,000 people (95% CI:0.0-0.5) in 1973 and was 1.2 per 1,000,000 people (95% Cl:0.8-1.6) in 2014 (average annual percent change:3.0% [95% CI:2.2%-3.7%]).Patients tended to be of older age (mean age:70.5 [range 15.0-102.0]),of female sex (62.8%),and Caucasian (81.1%).Finally,survival over time remained the same,as median disease specific survival months was 4.00 (95% CI:2.26-5.74) from 1995 to 1999 and 4.00 (95% Cl:3.26-4.74) from 2010 to 2014.Conclusions:The incidence rate of anaplastic thyroid cancer has increased from 1973 to 2014.Interestingly,median survival in months did not greatly change overtime.Based on this increasing incidence,physicians must act appropriately to identify patients with anaplastic thyroid cancer as it possesses a high morbidity and mortality.展开更多
Dysregulation of genes perpetuates cancer progression.During carcinogenesis,cancer cells acquire dependency of aberrant transcriptional programs(known as“transcription addiction”)to meet the high demands for uncontr...Dysregulation of genes perpetuates cancer progression.During carcinogenesis,cancer cells acquire dependency of aberrant transcriptional programs(known as“transcription addiction”)to meet the high demands for uncontrolled proliferation.The needs for particular transcription programs for cancer growth could be cancer-type-selective.The dependencies of certain transcription regulators could be exploited for therapeutic benefits.Anaplastic thyroid cancer(ATC)is an extremely aggressive human cancer for which new treatment modalities are urgently needed.Its resistance to conventional treatments and the lack of therapeutic options for improving survival might have been attributed to extensive genetic heterogeneity due to subsequent evolving genetic alterations and clonal selections during carcinogenesis.Despite this genetic complexity,mounting evidence has revealed a characteristic transcriptional addiction of ATC cells resulting in evolving diverse oncogenic signaling for cancer cell survival.The transcriptional addiction has presented a huge challenge for effective targeting as shown by the failure of previous targeted therapies.However,an emerging notion is that many different oncogenic signaling pathways activated by multiple upstream driver mutations might ultimately converge on the transcriptional responses,which would provide an opportunity to target transcriptional regulators for treatment of ATC.Here,we review the current understanding of how genetic alterations in cancer distorted the transcription program,leading to acquisition of transcriptional addiction.We also highlight recent findings from studies aiming to exploit the opportunity for targeting transcription regulators as potential therapeutics for ATC.展开更多
文摘The review article by Pavlidis et al published in World J Clin Oncol provides a meticulous analysis of the intricacies surrounding anaplastic carcinoma of the thyroid.Thyroid carcinoma encompasses a spectrum of diseases,each charac-terized by distinct behaviors and outcomes.Diagnostic approaches encompass a diverse array of tools.Surgery remains the pivotal treatment for anaplastic thyroid carcinoma.Radiotherapy and chemotherapy offer the best overall sur-vival in aggressive disease.Combinations of immunotherapy with targeted the-rapies,such as dabrafenib-trametinib,demonstrate potential for enhanced effect-iveness and improved survival outcomes.Multifaceted approach fuelled by precision medicine and interdisciplinary collaboration is imperative in charting a course toward improved outcomes in this formidable malignancy.
文摘Thyroid carcinoma is a complex disease with several types,the most common being well-differentiated and undifferentiated.The latter,“undifferentiated carcinoma”,also known as anaplastic thyroid carcinoma(ATC),is a highly aggr-essive malignant tumor accounting for less than 0.2%of all thyroid carcinomas and carries a poor prognosis with a median survival of 5 months.BRAF gene mutations are the most common molecular factor associated with this type of thyroid carcinoma.Recent advances in targeted biological agents,immuno-therapy,stem cell therapy,nanotechnology,the dabrafenib/trametinib com-bination therapy,immune checkpoint inhibitors(ICI)and artificial intelligence offer novel treatment options.The combination therapy of dabrafenib and tra-metinib is the current standard treatment for patients with BRAF-V600E gene mutations.Besides,the dabrafenib/trametinib combination therapy,ICI,used alone or in combination with targeted therapies have raised some hopes for improving the prognosis of this deadly disease.Younger age,earlier tumor stage and radiotherapy are all prognostic factors for improved outcomes.Ultimately,therapeutic regimens should be tailored to the individual patient based on surveillance and epidemiological data,and a multidisciplinary approach is ess-ential.
文摘Background: Anaplastic thyroid cancer (ATC), while rare, carries a uniformly poor prognosis. Current treatment includes surgery when possible, radiotherapy, and chemotherapy. Multiple chemotherapeutic agents are in the process of clinical testing, and promising agents include those in the tyrosine kinase inhibitor family. Our patient represents a novel case of ATC treated with sunitinib, one such tyrosine kinase inhibitor. Methods/Results: We utilized the experimental sunitinib in conjunction with radiation therapy to treat a patient with aggressive ATC in whom curative resection was unable to be achieved due to carotid sheath and tracheal involvement. The patient had marked clinical response and sustained stable disease for 8 months, which coincides with reported data regarding sunitinib to treat other thyroid malignancies. Conclusion: Our case illustrates the efficacy of sunitinib therapy as a possible adjunct in the treatment of ATC.
文摘Anaplastic thyroid carcinoma(ATC)is the rarest,but deadliest histologic type among thyroid malignancies,with a dismal median survival of 3-9 mo.Even though ATC accounts for less than 2%of all thyroid tumors,it is responsible for 14%-39%of thyroid carcinoma-related deaths.ATC clinically presents as a rapidly growing mass in the neck,associated with dyspnoea,dysphagia and vocal cord paralysis.It is usually locally advanced and often metastatic at initial presentation.For operable diseases,the combination of radical surgery with adjuvant radiotherapy or chemotherapy,using agents such as doxorubicin and cisplatin,is the best treatment strategy.Cytotoxic drugs for advanced/metastatic ATC are poorly effective.On the other hand,targeted agents might represent a viable therapeutic option.Axitinib,combretastatin A4,sorafenib and imatinib have been tested in small clinical trials of ATC,with a promising disease control rate ranging from 33%to 75%.Other clinical trials of targeted therapy for thyroid carcinoma are currently ongoing.Biological agents that are under investigation include pazopanib,gefitinib and everolimus.With the very limited therapeutic armamentarium available at the present time,targeted therapy constitutes an exciting new horizon for ATC.In future,biological agents will probably represent the standard of care for this aggressive malignancy,in the same fashion as it has recently occurred for other chemo-refractory tumors,such as kidney and hepatic cancer.
文摘The prognosis of small cell thyroid carcinoma(SCTC)in a large cohort has not been well reported in the literature.In this study,we analyzed the mortality of SCTC,in comparison to medullary thyroid cancer(MTC)and anaplastic thyroid cancer(ATC),based on the Surveillance,Epidemiology,and End Results(SEER)Program of the National Cancer Institute,to determine the prognosis of SCTC.Information regarding patients with a diagnosis of MTC,ATC,or SCTC,between 2004 and 2013,was acquired from the SEER database.Patient survival curves were assessed by Cox proportional hazards regression analyses,Kaplan-Meier analyses,and log-rank tests.In a Kaplan-Meier analysis of the entire cohort of thyroid cancer patients,cancer-specific survival declined sharply for patients with SCTC,but it declined more modestly for patients with MTC.The cancer-specific survival was not significantly different between SCTC and ATC.Unadjusted Cox regression analysis showed that SCTC had a higher cancer-specific mortality than MTC but a similar prognosis as ATC.SCTC showed a higher cancer-specific mortality than MTC and ATC after adjustments for various confounding factors.SCTC was found to have a more highly lethal clinical course than MTC and had a similar death rate to ATC.Therefore,we recommend that aggressive,radical treatment like surgery or radiation should be performed tor these patients.
文摘Well-differentiated thyroid carcinoma has a favorable prognosis with a 5-year survival rate of over 95%.However,the undifferentiated or anaplastic type accounting for<0.2%,usually in elderly individuals,exhibits a dismal prognosis with rapid growth and disappointing outcomes.It is the most aggressive form of thyroid carcinoma,with a median survival of 5 mo and poor quality of life(airway obstruction,dysphagia,hoarseness,persistent pain).Early diagnosis and staging are crucial.Diagnostic tools include biopsy(fine needle aspiration,core needle,open surgery),high-resolution ultrasound,computed tomography,magnetic resonance imaging,[(18)F]fluoro-D-glucose positron emission tomography/computed tomography,liquid biopsy and microRNAs.The BRAF gene(BRAF-V600E and BRAF wild type)is the most often found molecular factor.Others include the genes RET,KRAS,HRAS,and NRAS.Recent management policy is based on surgery,even debulking,chemotherapy(cisplatin or doxorubicin),radiotherapy(adjuvant or definitive),targeted biological agents and immunotherapy.The last two options constitute novel hopeful management modalities improving the overall survival in these otherwise condemned patients.Anti-programmed death-ligand 1 antibody immunotherapy,stem cell targeted therapies,nanotechnology achievements and artificial intelligence implementation provide novel promising alternatives.Genetic mutations determine molecular pathways,thus indicating novel treatment strategies such as anti-BRAF,anti-vascular endothelial growth factor-A,and anti-epidermal growth factor receptor.Treatment with the combination of the BRAF inhibitor dabrafenib and the MEK inhibitor trametinib has been approved by the Food and Drug Administration in cases with BRAF-V600E gene mutations and is currently the standard care.This neoadjuvant treatment followed by surgery ensures a twoyear overall survival of 80%.Prognostic factors for improved outcomes have been found to be younger age,earlier tumor stage and radiation therapy.A multidisciplinary approach is necessary,and the therapeutic plan should be individu alized based on surveillance and epidemiology end results.
文摘Anaplastic thyroid carcinoma (ATC) is a poorly differentiated thyroid cancer. It cannot uptake iodine or synthesis thyroglobulin. The incidence is low;about 2% - 5% of thyroid cancer. The peak age incidence is 60 - 70 years and it is more common in females (55% - 77% of all patients). In recent years, the incidence has declined;however, it may be higher in areas of endemic goiter. ATC may occur with a coexisting carcinoma and may represent transformation of a well-differentiated thyroid cancer. Patients typically present with a rapidly growing anterior neck mass and aggressive symptoms. The most reliable tool in detecting thyroid malignancies is fine-needle aspiration cytology (FNAC). Sensitivity of FNAC for thyroid malignancy ranged from 61% to 97.7%. Fine-needle aspiration can diagnose ATC by the demonstration of spindled or giant cells, bizarre neoplastic cells that may be multinucleated, or atypical cells with high mitotic activity. A syncytial pattern is the predominant cellular pattern of anaplastic thyroid carcinoma. Other laboratory tests, including tumor markers (cytokeratin, vimentin, and carcinoembryogenic antigen) are helpful in diagnosis and follow-up of the patients. Multimodality therapy (surgery, external beam radiation, and chemotherapy) is the recommended treatment and it seems to have slightly improved outcomes. The prognosis is not as bad in younger patients with smaller tumors. The most common cause of death is lung metastasis. The mean survival time is less than 6 months from the time of diagnosis. The prompt diagnosis and aggressive treatment are essential modality to achieve optimal outcomes.
文摘Anaplastic thyroid cancer is an uncommon malignancy with a poor prognosis. Elderly patients are most commonly afflicted and survival past 3 years occurs in less than 5% of patients. Management of these patients is challenging, and the importance of palliation, airway protection, and aggressive resection is debated. In this report, we describe a patient with anaplastic thyroid carcinoma who presented with respiratory distress due to invasion of the tracheal cartilage. The patient was managed with cricotracheal resection, total thyroidectomy and thyrotracheal anastomosis. The patient is currently disease free 3.5 years after resection and postoperative radiation therapy with interval neck dissection.
文摘Background and objective: Thyroid cancer is the most common endocrine malignancy. This report aims to describe the pattern of thyroid cancer presentations at King Abdulaziz University Hospital, Jeddah. Methods: This was a retrospect chart review of all thyroid cancer cases diagnosed between 2001 and 2010 at King Abdulaziz University Hospital, Jeddah. We documented patients’ demographic and clinical data, including age at diagnosis, tumor type and size, extrathyroidal extension, and metastasis. Results: A total of 114 thyroid cancer cases were diagnosed from 2001 through 2010. Females comprise the majority of cases (female to male ratio of 4:1). The mean ages of patients diagnosed with different thyroid cancers were: papillary thyroid cancer, 39.6 years;follicular thyroid cancer, 43.2 years;medullary thyroid cancer, 55.8 years;and anaplastic thyroid cancer, 46.0 years. Papillary thyroid cancer was diagnosed in 88 cases (77%), follicular thyroid cancer in 19 cases (17%), medullary thyroid cancer in 5 cases (4%), and anaplastic thyroid cancer in 2 cases (2%). Conclusion: Thyroid cancers are more common among females. The disease is diagnosed at a relatively young age among our patients (40 years). Papillary thyroid cancer is the most common type of thyroid cancer.
文摘Objective:To provide an understanding of the incidence of anaplastic thyroid cancer within the United States.Methods:Patients in the Surveillance,Epidemiology,and End Results (SEER) database were included from 1973 to 2014 based on a diagnosis of anaplastic thyroid cancer using ICDO-3 codes.Patients were categorized into cohorts based on their year of diagnosis.Results:1527 patients were diagnosed with anaplastic thyroid cancer within the SEER 18 registries.The age-adjusted incidence rate was 0.2 per 1,000,000 people (95% CI:0.0-0.5) in 1973 and was 1.2 per 1,000,000 people (95% Cl:0.8-1.6) in 2014 (average annual percent change:3.0% [95% CI:2.2%-3.7%]).Patients tended to be of older age (mean age:70.5 [range 15.0-102.0]),of female sex (62.8%),and Caucasian (81.1%).Finally,survival over time remained the same,as median disease specific survival months was 4.00 (95% CI:2.26-5.74) from 1995 to 1999 and 4.00 (95% Cl:3.26-4.74) from 2010 to 2014.Conclusions:The incidence rate of anaplastic thyroid cancer has increased from 1973 to 2014.Interestingly,median survival in months did not greatly change overtime.Based on this increasing incidence,physicians must act appropriately to identify patients with anaplastic thyroid cancer as it possesses a high morbidity and mortality.
基金supported by the Intramural Research Program of the Center for Cancer ResearchNational Cancer Institute,National Institutes of Health(ZIA BC 011191).
文摘Dysregulation of genes perpetuates cancer progression.During carcinogenesis,cancer cells acquire dependency of aberrant transcriptional programs(known as“transcription addiction”)to meet the high demands for uncontrolled proliferation.The needs for particular transcription programs for cancer growth could be cancer-type-selective.The dependencies of certain transcription regulators could be exploited for therapeutic benefits.Anaplastic thyroid cancer(ATC)is an extremely aggressive human cancer for which new treatment modalities are urgently needed.Its resistance to conventional treatments and the lack of therapeutic options for improving survival might have been attributed to extensive genetic heterogeneity due to subsequent evolving genetic alterations and clonal selections during carcinogenesis.Despite this genetic complexity,mounting evidence has revealed a characteristic transcriptional addiction of ATC cells resulting in evolving diverse oncogenic signaling for cancer cell survival.The transcriptional addiction has presented a huge challenge for effective targeting as shown by the failure of previous targeted therapies.However,an emerging notion is that many different oncogenic signaling pathways activated by multiple upstream driver mutations might ultimately converge on the transcriptional responses,which would provide an opportunity to target transcriptional regulators for treatment of ATC.Here,we review the current understanding of how genetic alterations in cancer distorted the transcription program,leading to acquisition of transcriptional addiction.We also highlight recent findings from studies aiming to exploit the opportunity for targeting transcription regulators as potential therapeutics for ATC.
