Scott Glaser1, Steven F. Mandish2, B.S. Gill1, G.K. Balasubramani3, D.A. Clump1, Sushil Beriwal1
1Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
2Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia
3Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
Tóm tắt
AbstractBackgroundAnaplastic thyroid cancer (ATC) represents a rare, aggressive malignancy. We analyzed factors predictive for overall survival (OS) and treatment modality utilization.MethodsUsing the National Cancer Data Base, we identified 3552 patients with ATC. Factors associated with surgery, high‐dose radiotherapy (RT; ≥59.4 Gy), and chemotherapy utilization were evaluated using multivariable logistic regression. From this, an inverse probability‐weighted propensity score was incorporated into multivariable Cox regression analyses for OS.ResultsNumerous factors predictive for high‐dose RT, total thyroidectomy, and chemotherapy utilization are described. Factors associated with improved survival were absence of clinical or pathologic lymph node involvement, absence of metastasis, tumor size ≤6 cm, negative surgical margins, surgery, RT, and chemotherapy. On conditional landmark analysis, improved survival seen with chemotherapy and surgery other than total thyroidectomy was lost, but persisted for total thyroidectomy and high‐dose RT.ConclusionEven after correction for selection and immortal time bias, high‐dose RT resulted in improved survival. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2083–E2090, 2016
