PDF(Pubmed)
Abstract：
UNASSIGNED: The clinic-pathological boundary between poorly differentiated thyroid cancer (PDTC) and anaplastic thyroid cancer (ATC) is unclear due to a wide spectrum of histopathological features and the rarity of the disease. In addition to that, with the highest mortality rate and non-standard treatment modality, the PDTC/ATC population has not been subjected to comprehensive description and comparison with the extent of histological characteristics, therapeutic response, prognostic factors, and death attribution analysis.
UNASSIGNED: A total of 4,947 PDTC/ATC patients from 2000 to 2018 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier survival curve estimation and Cox proportional hazard regression were applied.
UNASSIGNED: Overall, the 5- and 10-year DSS for PDTC were 71.9% and 68.0%, respectively, whereas the 5- and 10-year OS are 59.3% and 51.2%, respectively. The median survival time for ATC patients was 3 months with 1-year OS being 26.9% and 1-year DSS being 31.2%. During the follow-up period, 68.1% of the PDTC/ATC cohort were dead, 51.6% of which were attributed to thyroid malignancies and 16.5% to non-thyroid causes. The top three common non-thyroid causes of death were miscellaneous cancers, lower respiratory system disease, and heart disease. The histological feature of papillary thyroid cancer (PTC) was the leading pathological category for PDTC patients (51.7%), whereas 76.7% of ATC patients\' pathological feature was characterized as unidentifiable. Sarcoma histological characteristics found in ATC cases suffer the highest overall mortality (vs. PTC, HR = 2.61, 95% CI 1.68-4.06, P < 0.001). Older age unidentifiable histology feature, more advanced AJCC N1b, AJCC M1, and SEER stage, tumor size larger than 5 cm, and more invasive tumor extension were independent bad outcome predictors.
UNASSIGNED: The populational analysis of the PDTC/ATC cohort has provided reliable support for better understanding of the difference between PDTC and ATC cases and the guidance of clinical practice and further studies.
UNASSIGNED: A total of 4,947 PDTC/ATC patients from 2000 to 2018 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier survival curve estimation and Cox proportional hazard regression were applied.
UNASSIGNED: Overall, the 5- and 10-year DSS for PDTC were 71.9% and 68.0%, respectively, whereas the 5- and 10-year OS are 59.3% and 51.2%, respectively. The median survival time for ATC patients was 3 months with 1-year OS being 26.9% and 1-year DSS being 31.2%. During the follow-up period, 68.1% of the PDTC/ATC cohort were dead, 51.6% of which were attributed to thyroid malignancies and 16.5% to non-thyroid causes. The top three common non-thyroid causes of death were miscellaneous cancers, lower respiratory system disease, and heart disease. The histological feature of papillary thyroid cancer (PTC) was the leading pathological category for PDTC patients (51.7%), whereas 76.7% of ATC patients\' pathological feature was characterized as unidentifiable. Sarcoma histological characteristics found in ATC cases suffer the highest overall mortality (vs. PTC, HR = 2.61, 95% CI 1.68-4.06, P < 0.001). Older age unidentifiable histology feature, more advanced AJCC N1b, AJCC M1, and SEER stage, tumor size larger than 5 cm, and more invasive tumor extension were independent bad outcome predictors.
UNASSIGNED: The populational analysis of the PDTC/ATC cohort has provided reliable support for better understanding of the difference between PDTC and ATC cases and the guidance of clinical practice and further studies.
摘要：
■由于广泛的组织病理学特征和罕见的疾病，低分化甲状腺癌（PDTC）和间变性甲状腺癌（ATC）之间的临床病理边界尚不清楚。除此之外,死亡率最高，治疗方式不规范，PDTC/ATC人群没有进行全面的描述，并与组织学特征的程度进行比较，治疗反应，预后因素，和死亡归因分析。
■从监测中确定了2000年至2018年的4,947名PDTC/ATC患者。流行病学,和结束结果(SEER)数据库。应用Kaplan-Meier存活曲线估计和Cox比例风险回归。
■总的来说，PDTC的5年和10年DSS分别为71.9%和68.0%，分别,而5年和10年OS分别为59.3%和51.2%，分别。ATC患者的中位生存时间为3个月，1年OS为26.9%，1年DSS为31.2%。在后续期间,68.1％的PDTC/ATC队列死亡，其中51.6％归因于甲状腺恶性肿瘤，16.5％归因于非甲状腺原因。前三个常见的非甲状腺死亡原因是其他癌症，下呼吸系统疾病,还有心脏病.甲状腺乳头状癌（PTC）的组织学特征是PDTC患者的主要病理类型（51.7％），而76.7%的ATC患者病理特征为无法识别。在ATC病例中发现的肉瘤组织学特征遭受最高的总死亡率（与PTC,HR=2.61，95%CI1.68-4.06，P<0.001）。年龄较大的无法识别的组织学特征，更先进的AJCCN1b，AJCCM1和SEER阶段，肿瘤大小大于5厘米，和更多的侵袭性肿瘤扩展是独立的不良预后预测因子。
■PDTC/ATC队列的人群分析为更好地理解PDTC和ATC病例之间的差异以及临床实践和进一步研究的指导提供了可靠的支持。
■从监测中确定了2000年至2018年的4,947名PDTC/ATC患者。流行病学,和结束结果(SEER)数据库。应用Kaplan-Meier存活曲线估计和Cox比例风险回归。
■总的来说，PDTC的5年和10年DSS分别为71.9%和68.0%，分别,而5年和10年OS分别为59.3%和51.2%，分别。ATC患者的中位生存时间为3个月，1年OS为26.9%，1年DSS为31.2%。在后续期间,68.1％的PDTC/ATC队列死亡，其中51.6％归因于甲状腺恶性肿瘤，16.5％归因于非甲状腺原因。前三个常见的非甲状腺死亡原因是其他癌症，下呼吸系统疾病,还有心脏病.甲状腺乳头状癌（PTC）的组织学特征是PDTC患者的主要病理类型（51.7％），而76.7%的ATC患者病理特征为无法识别。在ATC病例中发现的肉瘤组织学特征遭受最高的总死亡率（与PTC,HR=2.61，95%CI1.68-4.06，P<0.001）。年龄较大的无法识别的组织学特征，更先进的AJCCN1b，AJCCM1和SEER阶段，肿瘤大小大于5厘米，和更多的侵袭性肿瘤扩展是独立的不良预后预测因子。
■PDTC/ATC队列的人群分析为更好地理解PDTC和ATC病例之间的差异以及临床实践和进一步研究的指导提供了可靠的支持。
