The role of surgery for anaplastic thyroid carcinoma in the era of targeted therapeutics: A scoping review
Abstract Background Questions exist regarding patient selection for surgery in anaplastic thyroid carcinoma (ATC), particularly with the advent of neoadjuvant‐targeted therapeutics. The present scoping review sought to evaluate what extent of surgical resection should be performed in ATC. Methods A...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-12-01
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| Series: | Laryngoscope Investigative Otolaryngology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/lio2.1172 |
| _version_ | 1797384841185984512 |
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| author | Eoin F. Cleere Thomas J. Crotty Justin M. Hintze Conall W. R. Fitzgerald John Kinsella Paul Lennon Conrad V. I. Timon Robbie S. R. Woods Neville P. Shine James P. O'Neill |
| author_facet | Eoin F. Cleere Thomas J. Crotty Justin M. Hintze Conall W. R. Fitzgerald John Kinsella Paul Lennon Conrad V. I. Timon Robbie S. R. Woods Neville P. Shine James P. O'Neill |
| author_sort | Eoin F. Cleere |
| collection | DOAJ |
| description | Abstract Background Questions exist regarding patient selection for surgery in anaplastic thyroid carcinoma (ATC), particularly with the advent of neoadjuvant‐targeted therapeutics. The present scoping review sought to evaluate what extent of surgical resection should be performed in ATC. Methods A scoping review was carried out in accordance with Joanna Briggs Institute and the preferred reporting items for systematic reviews and meta‐analyses extension for scoping reviews (PRISMA‐ScR) protocols. Included studies were required to provide clear description of the surgery performed for ATC. Results The final search identified 6901 articles. Ultimately only 15 articles including 1484 patients met inclusion criteria. A total of 765 patients (51.5%) underwent attempted curative intent surgery. The approach to resection of adjacent tissues varied between studies. Eight studies considered laryngeal ± pharyngeal resection (8/15, 53.3%), eight studies (53.3%) considered tracheal resection and again eight studies (53.3%) considered esophageal resection. More extensive resections increased morbidity without improving overall survival (OS) (<9 months in the 12 studies using a combination of surgery and chemoradiotherapy). In the three studies utilizing targeted therapy in addition to surgery, OS was notably improved while surgical resection following neoadjuvant therapy was less extensive. Conclusions There is no clear agreement in the literature regarding the limits of surgical resection in locoregionally advanced ATC. A definition of surgically resectable disease will be required to guide surgical decision making in ATC, particularly with the potential to reduce tumor burden using neoadjuvant targeted treatment in suitable patients. Level of evidence III |
| first_indexed | 2024-03-08T21:45:27Z |
| format | Article |
| id | doaj.art-e6e7dba1616c4f01a2c23ebdd77c8a81 |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-03-08T21:45:27Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-e6e7dba1616c4f01a2c23ebdd77c8a812023-12-20T09:48:35ZengWileyLaryngoscope Investigative Otolaryngology2378-80382023-12-01861673168410.1002/lio2.1172The role of surgery for anaplastic thyroid carcinoma in the era of targeted therapeutics: A scoping reviewEoin F. Cleere0Thomas J. Crotty1Justin M. Hintze2Conall W. R. Fitzgerald3John Kinsella4Paul Lennon5Conrad V. I. Timon6Robbie S. R. Woods7Neville P. Shine8James P. O'Neill9Department of Otolaryngology Head and Neck Surgery, Beaumont Hospital Dublin IrelandDepartment of Otolaryngology Head and Neck Surgery, St James's Hospital Dublin IrelandDepartment of Otolaryngology Head and Neck Surgery, St James's Hospital Dublin IrelandDepartment of Otolaryngology Head and Neck Surgery, St James's Hospital Dublin IrelandDepartment of Otolaryngology Head and Neck Surgery, St James's Hospital Dublin IrelandDepartment of Otolaryngology Head and Neck Surgery, St James's Hospital Dublin IrelandDepartment of Otolaryngology Head and Neck Surgery, St James's Hospital Dublin IrelandDepartment of Otolaryngology Head and Neck Surgery, Beaumont Hospital Dublin IrelandDepartment of Otolaryngology Head and Neck Surgery, Beaumont Hospital Dublin IrelandDepartment of Otolaryngology Head and Neck Surgery, Beaumont Hospital Dublin IrelandAbstract Background Questions exist regarding patient selection for surgery in anaplastic thyroid carcinoma (ATC), particularly with the advent of neoadjuvant‐targeted therapeutics. The present scoping review sought to evaluate what extent of surgical resection should be performed in ATC. Methods A scoping review was carried out in accordance with Joanna Briggs Institute and the preferred reporting items for systematic reviews and meta‐analyses extension for scoping reviews (PRISMA‐ScR) protocols. Included studies were required to provide clear description of the surgery performed for ATC. Results The final search identified 6901 articles. Ultimately only 15 articles including 1484 patients met inclusion criteria. A total of 765 patients (51.5%) underwent attempted curative intent surgery. The approach to resection of adjacent tissues varied between studies. Eight studies considered laryngeal ± pharyngeal resection (8/15, 53.3%), eight studies (53.3%) considered tracheal resection and again eight studies (53.3%) considered esophageal resection. More extensive resections increased morbidity without improving overall survival (OS) (<9 months in the 12 studies using a combination of surgery and chemoradiotherapy). In the three studies utilizing targeted therapy in addition to surgery, OS was notably improved while surgical resection following neoadjuvant therapy was less extensive. Conclusions There is no clear agreement in the literature regarding the limits of surgical resection in locoregionally advanced ATC. A definition of surgically resectable disease will be required to guide surgical decision making in ATC, particularly with the potential to reduce tumor burden using neoadjuvant targeted treatment in suitable patients. Level of evidence IIIhttps://doi.org/10.1002/lio2.1172anaplasticsurgerytargeted therapythyroidunresectable |
| spellingShingle | Eoin F. Cleere Thomas J. Crotty Justin M. Hintze Conall W. R. Fitzgerald John Kinsella Paul Lennon Conrad V. I. Timon Robbie S. R. Woods Neville P. Shine James P. O'Neill The role of surgery for anaplastic thyroid carcinoma in the era of targeted therapeutics: A scoping review Laryngoscope Investigative Otolaryngology anaplastic surgery targeted therapy thyroid unresectable |
| title | The role of surgery for anaplastic thyroid carcinoma in the era of targeted therapeutics: A scoping review |
| title_full | The role of surgery for anaplastic thyroid carcinoma in the era of targeted therapeutics: A scoping review |
| title_fullStr | The role of surgery for anaplastic thyroid carcinoma in the era of targeted therapeutics: A scoping review |
| title_full_unstemmed | The role of surgery for anaplastic thyroid carcinoma in the era of targeted therapeutics: A scoping review |
| title_short | The role of surgery for anaplastic thyroid carcinoma in the era of targeted therapeutics: A scoping review |
| title_sort | role of surgery for anaplastic thyroid carcinoma in the era of targeted therapeutics a scoping review |
| topic | anaplastic surgery targeted therapy thyroid unresectable |
| url | https://doi.org/10.1002/lio2.1172 |
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