WordNet

type genus of the family Cancridae (同)genus Cancer
the fourth sign of the zodiac; the sun is in this sign from about June 21 to July 22 (同)Cancer the Crab, Crab
(astrology) a person who is born while the sun is in Cancer (同)Crab
a small zodiacal constellation in the northern hemisphere; between Leo and Gemini
any malignant growth or tumor caused by abnormal and uncontrolled cell division; it may spread to other parts of the body through the lymphatic system or the blood stream (同)malignant neoplastic disease
suggestive of a thyroid disorder; "thyroid personality"
of or relating to the thyroid gland; "thyroid deficiency"; "thyroidal uptake" (同)thyroidal
of or relating to anaplasia

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〈U〉〈C〉『がん』 / 〈U〉〈C〉害悪 / 《Cancer》(星座の)カニ座
甲状腺 / 甲状腺の

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/03/17 09:08:08」(JST)

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Anaplastic thyroid cancer (ATC) is a form of thyroid cancer which has a very poor prognosis due to its aggressive behavior and resistance to cancer treatments.^[1]

§Presentation

Anaplastic thyroid cancer in Ultrasound

Anaplastic tumors have a high mitotic rate and lymphovascular invasion.^[2] It rapidly invades surrounding tissues (such as the trachea). The presence of regional lymphadenopathy in older patients in whom needle aspiration biopsy reveals characteristic vesicular appearance of the nuclei would support a diagnosis of anaplastic carcinoma.

It always considered as stage IV.^[3]

§Prognosis

The overall 5-year survival rate of anaplastic thyroid cancer has been given as 7%^[4] or 14%,^[5] although the latter has been criticized as being overestimated.^[5]

Treatment of anaplastic-type carcinoma is generally palliative in its intent for a disease that is rarely cured and almost always fatal, with worse prognosis associated with large tumours, distant metastases, acute obstructive symptoms, and leukocytosis. Death is attributable to upper airway obstruction and suffocation in half of patients, and to a combination of complications of local and distant disease, or therapy, or both in the remainder.

Anaplastic thyroid cancer is extremely aggressive; in most cases death occurs in less than 1 year as a result of aggressive local growth and compromise of vital structures in the neck. ATC in most series has a median survival of 4 to 5 months from the time of diagnosis, with rare long-term survivors.^[6]

§Treatment

Unlike its differentiated counterparts, anaplastic thyroid cancer is highly unlikely to be curable either by surgery or by any other treatment modality, and is in fact usually unresectable due to its high propensity for invading surrounding tissues.^[7]

Palliative treatment consists of radiation therapy usually combined with chemotherapy.

However, with today's technology, new drugs, such as fosbretabulin (a type of combretastatin), bortezomib and TNF-Related Apoptosis Induced Ligand (TRAIL), are being introduced and trialed in clinical labs and human clinical studies. Based on encouraging Phase I and II clinical trial results, with fosbretabulin, a type of drug that selectively destroys tumor blood vessels, a large, multi-national clinical trial is being undertaken to determine whether the drug can extend the survival of patients with ATC. Recent studies in Italy have shown positive results against ATC, but more tests outside the lab are needed to confirm this before it can be used in chemotherapy. There have been some case studies where patients with aggressive thyroid cancer have survived outside the mean expected survival time.

§Post-operative radiotherapy

The role of external beam radiotherapy (EBRT) in thyroid cancer remains controversial and there is no level I evidence to recommend its use in the setting of differentiated thyroid cancers such as papillary and follicular carcinomas. Anaplastic thyroid carcinomas, however, are histologically distinct from differentiated thyroid cancers and due to the highly aggressive nature of ATC aggressive postoperative radiation and chemotherapy are typically recommended.

The National Comprehensive Cancer Network Clinical Practice Guidelines currently recommend that postoperative radiation and chemotherapy be strongly considered. No published randomised controlled trials have examined the addition of EBRT to standard treatment, namely surgery. Radioactive iodine is typically ineffective in the management of ATC as it is not an iodine-avid cancer.^[8]

Imbalances in age, sex, completeness of surgical excision, histological type and stage, between patients receiving and not receiving EBRT, confound retrospective studies. Variability also exists between treatment and non-treatment groups in the use of radio-iodine and post-treatment thyroid stimulating hormone (TSH) suppression and treatment techniques between and within retrospective studies.

Some recent studies have indicated that EBRT may be promising, though the number of patients studies has been small.^[9]

Clinical trials for investigational treatments are often considered by healthcare professionals and patients as first-line treatment.

§Adjuvant therapy

In the absence of extracervical or unresectable disease, surgical excision should be followed by adjuvant radiotherapy. In the 18–24% of patients whose tumour seems both confined to the neck and grossly resectable, complete surgical resection followed by adjuvant radiotherapy and chemotherapy could yield a 75–80% survival at 2 years.

There are a number of clinical trials for anaplastic thyroid carcinoma underway or being planned.^[10]

§References

^ Liu AH, Juan LY, Yang AH, Chen HS, Lin HD (2006). "Anaplastic thyroid cancer with uncommon long-term survival". J Chin Med Assoc 69 (10): 489–91. doi:10.1016/S1726-4901(09)70314-4. PMID 17098674.
^ Hu MI, Vassilopoulou-Sellin R, Lustig R, Lamont JP. "Thyroid and Parathyroid Cancers" in Pazdur R, Wagman LD, Camphausen KA, Hoskins WJ (Eds) Cancer Management: A Multidisciplinary Approach. 11 ed. 2008.
^ Harrison's Principles of Internal Medicine, 18th edition, p.2934
^ cancer.org > Thyroid Cancer By the American Cancer Society. In turn citing: AJCC Cancer Staging Manual (7th ed).
^ ^a ^b Numbers from National Cancer Database in the US, from Page 10 in: F. Grünwald; Biersack, H. J.; Grںunwald, F. (2005). Thyroid cancer. Berlin: Springer. ISBN 3-540-22309-6. (Note:Book also states that the 14% 10-year survival for anaplastic thyroid cancer was overestimated)
^ Kumar V, Abbas AK, Fausto N, and Mitchel RN, "Robbins basic Pathology", Saunders, 8th ed., 2007.
^ Haigh PI (2000). "Anaplastic thyroid carcinoma". Curr Treat Options Oncol 1 (4): 353–7. doi:10.1007/s11864-000-0051-8. PMID 12057160.
^ Ford D; Giridharan S; McConkey C et al. (2003). "External beam radiotherapy in the management of differentiated thyroid cancer". Clin Oncol (R Coll Radiol) 15 (6): 337–41. doi:10.1016/S0936-6555(03)00162-6. PMID 14524487.
^ Meadows KM, Amdur RJ, Morris CG, Villaret DB, Mazzaferri EL, Mendenhall WM (2006). "External beam radiotherapy for differentiated thyroid cancer". Am J Otolaryngol 27 (1): 24–8. doi:10.1016/j.amjoto.2005.05.017. PMID 16360819.
^ "American Thyroid Association - Thyroid Clinical Trials". Archived from the original on 12 December 2007. Retrieved 2007-12-21.

UpToDate Contents

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1. 甲状腺未分化癌 anaplastic thyroid cancer
2. 甲状腺癌の治療における体外照射療法 external beam radiotherapy in the treatment of thyroid cancer
3. 甲状腺結節および非髄様甲状腺癌におけるオンコジーンおよび腫瘍抑制遺伝子 oncogenes and tumor suppressor genes in thyroid nodules and nonmedullary thyroid cancer
4. 浸潤性甲状腺疾患 infiltrative thyroid disease
5. 初回および再手術の甲状腺摘除術 initial and reoperative thyroidectomy

English Journal

Single agent nanoparticle for radiotherapy and radio-photothermal therapy in anaplastic thyroid cancer.

Zhou M1, Chen Y2, Adachi M2, Wen X1, Erwin B3, Mawlawi O3, Lai SY4, Li C5.
Biomaterials.Biomaterials.2015 Jul;57:41-9. doi: 10.1016/j.biomaterials.2015.04.013. Epub 2015 Apr 24.
Anaplastic thyroid carcinoma (ATC) is one of the most aggressive human malignancies. The aggressive behavior of ATC and its resistance to traditional treatment limit the efficacy of radiotherapy, chemotherapy, and surgery. The purpose of this study is aimed at enhancing the therapeutic efficacy of r
PMID 25913249

Carfilzomib is an effective anticancer agent in anaplastic thyroid cancer.

Mehta A1, Zhang L2, Boufraqech M2, Zhang Y2, Patel D2, Shen M2, Kebebew E3.
Endocrine-related cancer.Endocr Relat Cancer.2015 Jun;22(3):319-29. doi: 10.1530/ERC-14-0510.
Anaplastic thyroid cancer (ATC) is one of the most aggressive human malignancies. Currently, there is no standard or effective therapy for ATC. Drug repurposing for cancer treatment is an emerging approach for identifying compounds that may have antineoplastic effects. The aim of this study was to u
PMID 25972243

The role of BRAF in the pathogenesis of thyroid carcinoma.

Li DD, Zhang YF, Xu HX1, Zhang XP2.
Frontiers in bioscience (Landmark edition).Front Biosci (Landmark Ed).2015 Jun 1;20:1068-78.
BRAF is a cytoplasmic serine-threonine protein kinasethat plays a critical role in the MAPK signaling pathway. BRAF is the only member of the RAF family activated by mutation in human cancers. A single amino acid substitution (V600E) accounts for a multitude of human cancers, which causes constituti
PMID 25961545

Japanese Journal

専門医部会考えてみよう臨床クイズ問題急速に進行する大小不同の多発肺結節影を呈した症例

金子正博
日本内科学会雑誌 101(11), 3272-3273,3294-3295, 2012-11-10
NAID 40019493590

6. 甲状腺未分化癌長期生存例の解析(<特集>内分泌外科稀少疾患の日本の現状把握と診療指針の作成)

吉田明,松津賢一
日本外科学会雑誌 113(4), 373-377, 2012-07-01
NAID 110009479955

5. 甲状腺未分化癌研究コンソーシアム(<特集>内分泌外科稀少疾患の日本の現状把握と診療指針の作成)

杉谷巌
日本外科学会雑誌 113(4), 368-372, 2012-07-01
NAID 110009479954

Related Pictures

★リンクテーブル★

リンク元	「組織非形成性甲状腺癌」
関連記事	「anaplastic」「thyroid」「cancer」

「組織非形成性甲状腺癌」

Anaplastic thyroid cancer
	Micrograph of anaplastic thyroid carcinoma. H&E stain.
Classification and external resources
ICD-10	C73
ICD-9	193
MedlinePlus	000352
eMedicine	med/2687
MeSH	D013964

　　[★]

英: anaplastic thyroid cancer

「anaplastic」

　　[★]

未分化の、低分化の、退形成の

関: anaplasia、poorly-differentiated、undifferentiated

同: malignant astrocytoma, 退形成性悪性星状細胞腫

「thyroid」

　　[★]

n.

甲状腺

関: thyroid gland、thyroidal

「cancer」

　　[★]

同: 癌腫
関: tumor

[pmid17098674-1] Liu AH, Juan LY, Yang AH, Chen HS, Lin HD (2006). "Anaplastic thyroid cancer with uncommon long-term survival". J Chin Med Assoc 69 (10): 489–91. doi:10.1016/S1726-4901(09)70314-4. PMID 17098674.

[2] Hu MI, Vassilopoulou-Sellin R, Lustig R, Lamont JP. "Thyroid and Parathyroid Cancers" in Pazdur R, Wagman LD, Camphausen KA, Hoskins WJ (Eds) Cancer Management: A Multidisciplinary Approach. 11 ed. 2008.

[3] Harrison's Principles of Internal Medicine, 18th edition, p.2934

[acc-4] r.org > Thyroid Cancer By the American Cancer Society. In turn citing: AJCC Cancer Staging Manual (7th ed).

[american-5] Numbers from National Cancer Database in the US, from Page 10 in: F. Grünwald; Biersack, H. J.; Grںunwald, F. (2005). Thyroid cancer. Berlin: Springer. ISBN 3-540-22309-6. (Note:Book also states that the 14% 10-year survival for anaplastic thyroid cancer was overestimated)

[6] Kumar V, Abbas AK, Fausto N, and Mitchel RN, "Robbins basic Pathology", Saunders, 8th ed., 2007.

[pmid12057160-7] Haigh PI (2000). "Anaplastic thyroid carcinoma". Curr Treat Options Oncol 1 (4): 353–7. doi:10.1007/s11864-000-0051-8. PMID 12057160.

[pmid14524487-8] Ford D; Giridharan S; McConkey C et al. (2003). "External beam radiotherapy in the management of differentiated thyroid cancer". Clin Oncol (R Coll Radiol) 15 (6): 337–41. doi:10.1016/S0936-6555(03)00162-6. PMID 14524487.

[pmid16360819-9] Meadows KM, Amdur RJ, Morris CG, Villaret DB, Mazzaferri EL, Mendenhall WM (2006). "External beam radiotherapy for differentiated thyroid cancer". Am J Otolaryngol 27 (1): 24–8. doi:10.1016/j.amjoto.2005.05.017. PMID 16360819.

[titleAmerican_Thyroid_Association_-_Thyroid_Clinical_Trials-10] "American Thyroid Association - Thyroid Clinical Trials". Archived from the original on 12 December 2007. Retrieved 2007-12-21.

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案内

案内

anaplastic thyroid cancer