Endocrine Abstracts

Introduction: Thyroid carcinomas (TC) are rare; the incidence in the French Marne-Ardennnes thyroid registry is 10/100.000 in 2010. The 10 year survival rate is greater than 90%. Nevertheless some TC are refractory to conventional therapy.

Aim of the study: To describe frequency and clinical features of refractory TC (RTC).

Patients and methods: Retrospectiv study from the database of the registry. 1427 patients with TC were diagnosed between 01/01/1983 and 31/12/2005. We used AJCC, 6th edition. RTC included metastatic differentiated TC (DTC) refractory to radioiodine therapy, metastatic or locally advanced medullary TC (MTC), anaplastic TC (ATC).

Results: RTC represented 99/1427 (7%).

34 DTC: 2.5% of all DTC; 23 women, 11 men, mean age at diagnosis 63.5 years, mean tumor size 52.5 mm. 28/34 (82.3%) were stage pT3 or pT4 and 18/34 (52.9%) M1 at diagnosis. Classification has RTC occured after 40.8 months, mean survival was 7.8 years. 23.5% were papillary (2/18 papillary NOS, 1/18 follicular variant, 4/18 diffuse sclerosing, 1/18 columnar cell carcinoma); 53%, were follicular (1/18 minimally invasive; 5/18 widely invasive; 12/18 oxyphilic cell type) and 23.5% insular (8/34)

19 MTC: 22.6% of all MTC; 9 women, 10 men, mean age at diagnosis 59.3 years. 11/19 sporadic and 1 familial case, no genetic results for 7/19, mean tumor size 30 mm. 17/19 were stage IV. Mean survival was 4 years when they were M1 at diagnosis, 11 years for M0.

46 ATC: 33 women, 13 men, mean age at diagnosis 72.6 years, mean tumor size was 73.7 mm, 16/46 M1 at diagnosis. Mean survival was 7 month.

Conclusion: In this retrospectiv study 7% (99/1427) of all patients with TC are refractory: 34% DTC, 19% MTC and 47% ATC. 74% were diagnosed refractory at diagnosis and 26% during the follow-up. We need prospectiv epidemiological studies to confirm these preliminary results.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector