ETA2024 Poster Presentations Clinical thyroid cancer research-3 (10 abstracts)
Clinicopathological characteristics and outcome of patients with poorly differentiated thyroid cancer-a single center experience
Vasiliki Antonopoulou 1 , Theodora Stratigou 2 , Maria Zotou 3 , Dimitra Baikousi 3 , Chrysoula Koukoula 1 , Aikaterini Beka 1 , Kyriaki Gkoufa 1 , Olga Papalou 4 , Sofia Georgiadi 1 , Nikolaos Katechakis 5 , Efstratios Kardalas 6 , Dimitra Argyro Vassiliadi 7 , Marinella Tzanela 8 & Georgia Ntali 9
1Endo-Ern, Evangelismos General Hospital of Athens, Greece, Department of Endocrinology “d.Ikkos”-Diabetes Center, Athens, Greece; 2Endo-Ern, Evangelismos General Hospital of Athens, Greece, Department of Endocrinology“d.Ikkos”-Diabetes Center, Endo-Ern, Athens, Greece; 3Endo-Ern, Evangelismos General Hospital of Athens, Greece, Department of Endocrinology“d.Ikkos”-Diabetes Center, Athens, Greece; 4Evangelismos Hospital, Endo-Ern, Evangelismos General Hospital of Athens, Greece, Department of Endocrinology“d.Ikkos”-Diabetes Center, Athens, Greece; 5Oikismos Thiseas 33-12, Endo-Ern, Evangelismos General Hospital of Athens, Greece, Department of Endocrinology“d.Ikkos”-Diabetes Center, Gazion, Greece; 6General Hospital of Athens, Endo-Ern, Evangelismos General Hospital of Athens, Greece, Department of Endocrinology“d.Ikkos”-Diabetes Center, Athens, Greece; 7Endocrinology, Endo-Ern, Evangelismos General Hospital of Athens, Greece, Department of Endocrinology“d.Ikkos”-Diabetes Center, Athens, Greece; 8Department of Endocrinology, Evangelismos Hospital, Endo-Ern, Evangelismos General Hospital of Athens, Greece, Hcp, Athens, Greece; 9Endo-Ern, Evangelismos General Hospital of Athens, Greece, Department of Endocrinology“d.Ikkos”-Diabetes Center, Alimos, Athens, Greece
Background: Poorly differentiated thyroid cancer (PDTC) is a rare entity which originates from follicular epithelial cells and ranks between differentiated (DTC) and anaplastic TC (ATC).
Objective: Evaluation of clinicopathological characteristics and outcome in a series of 23 PDTC patients.
Methods: Retrospective analysis of histologically confirmed PDTC patients treated in the department of Endocrinology at Evangelismos Hospital from 2009 to 2023.
Results: 23 patients (13 males) with mean (±SD) age at diagnosis 63.6±12 years were identified. 6/23 (4 females) were diagnosed with PDTC during progression of papillary DTC. Clinicopathological characteristics are reported in the following table. Patients with de novo PDTC (n = 17,11 males) had mean age 65.8±12.7 years and median tumor length (Q1,Q3) 5.5 cm (3.6,7.5). 5/17 (29.4%) underwent concurrently total thyroidectomy+lymph-node (Ln) dissection. After I131 treatment thyroid bed uptake was observed in 10/14 (71.4%), 1 patient had no uptake, 3/14 (21.4%) retained I131 in distant lesions while for 3 data missed. 11/17 patients had a median (Q1,Q3) follow up period of 4 years (2,6) during which 4/11 had Ln dissection, all were treated with I131, 3/11 underwent external beam radiotherapy (EBRT) and 1/11 received tyrosine kinase inhibitors (TKIs). At last evaluation 7/11 patients had progressive disease (PD), 3/11 had stable disease (SD), 1 had complete remission (CR). 2/17 patients died 3 years after diagnosis. Both were males, >55 years old at diagnosis and stage IVB. Patients with diagnosis of DTC had mean age 57.5±8.7 years, 50% were ATA high risk and 3/6 had an aggressive variant. All were treated with I131 and had uptake in Ln and lung metastasis. PDTC occured 1-13 years after DTC diagnosis. 2 patients were reoperated, 3 were treated with I131, 4 received (TKIs) and 4 underwent (EBRT). 3 patients died on average 9.6 years after DTC diagnosis.
| Clinicopathological characteristics | At diagnosis of de novo PDTC | At diagnosis of DTC | |
| AJCC/TNM 8th | Stage I-II Stage III-IV | 13(76.4%) 4(23.5%) | 3(50%) 3(50%) |
| Primary tumor stage | pT1-T2 pT3-T4 | 4(23.5%) 13(76.4%) | 2(33.3%) 4(66.6%) |
| Εxtrathyroidal extension | Macroscopic Microscopic | 7(41.17%) 3(17.6%) | 2(33.3%) 1(16.7%) |
| Invasion | Lymph nodes Vascular | 5(29.4%) 10(58.9%) | 2(33.3%) 2(33.3%) |
| BRAFV600E mutation | Positive Negative Unknown | 1(5.9%) 5(29.4%) 11(64.7%) | 2(33.3%) 3(50%) 1(16.7%) |
| Ki-67 (%) | <10% 10-20% >20% Unknown | 0 6(35.3 %) 2(11.7 %) 9(52.9 %) | 1(16.7%) 0 0 5(83.3%) |
| Distant disease | Lungs Lungs+Liver Lungs+Brain | 3(17.6 %) 1(5.9%) 1(5.9%) | 1(16.7%) 0 0 |
Conclusions: PDTC is a rare and challenging entity. I131 treatment may be partially effective and other therapeutic modalities may be needed.
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