Super-radical surgery for anaplastic thyroid carcinoma: a large cohort study using the Anaplastic Thyroid Carcinoma Research Consortium of Japan database.

Background: The consequences of super-radical resection in patients with anaplastic thyroid carcinoma (ATC) have not been fully investigated.

Methods: This retrospective study used the multicenter ATC Research Consortium of Japan database. Among 233 stage IVB patients, 23 underwent super-radical resection (group S). Outcomes for group S were compared to those for patients with restricted curative surgery (group R; n = 49), palliative surgery (group P; n = 72) or no surgery (group N; n = 80).

Results: One-year cause-specific survival rate for group S was 33%. It was identical to group R (p = .94) and significantly better than groups N and P (p = .0065). Permanent tracheostomy was significantly more frequent in group S than in other groups, but only 5 patients died directly from local disease.

Conclusions: Radical resection offers significantly better outcomes than limited surgery. Super-radical procedures may be indicated in select patients to avoid mortality due to locally uncontrolled disease at the expense of tracheostomy.