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.