THE EFFICACY OF TARGETED NEOADJUVANT THERAPY FOR UNRESECTABLE THYROID CANCER IN ENABLING SURGICAL RESECTION rossi.leonardo.phd@gmail.com

 

THE EFFICACY OF TARGETED NEOADJUVANT THERAPY FOR UNRESECTABLE THYROID CANCER IN ENABLING SURGICAL RESECTION

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Italy

Oral only

The efficacy of targeted neoadjuvant therapy in converting unresectable thyroid cancers to resectable status is under investigation. This study aimed to assess its ability to make patients with non-resectable tumors suitable for surgery.

This retrospective study includes consecutive patients with locally-advanced thyroid carcinoma of any histology from November 2014 to December 2023 who underwent targeted neoadjuvant therapy.

A total of 18 patients were included. Of these, 14(77.8%) were male and 4(22.2%) female with a median age of 71 years. Extensive tracheal infiltration was observed in 14(77.8%) patients, esophageal infiltration in 12(66.7%), extensive laryngeal infiltration in 11(61.1%), carotid artery infiltration in 6(33.3%), mediastinal vessels infiltration in 6(33.3%), and vertebral infiltration in 4(22.2%). Circumferential encasement of carotid artery was present in 1(5.6%) patient. Sixteen(88.9%) patients were inoperable due to surgical criteria. Two(11.1%) patients were initially considered for total laryngectomy, but one(5.6%) was deemed unsuitable due to advanced age and diffuse metastatic disease, while the other(5.6%) declined surgery. Restaging CT-scan was performed in 16(88.9%) patients. Tumor volume reduction was observed in 11(61.1%) patients. Among patients deemed surgically unresectable, 15(93.8%) did not demonstrate a shift to resectable disease. Moreover, inoperability criteria remained unchanged in 13(86.7%) patients. One(5.6%) patient previously considered inoperable due to a 360° encasement of the carotid artery experienced a resolution and underwent successful surgery.

Targeted therapy for unresectable advanced thyroid cancer with organs infiltration has a limited impact in shifting patients to a resectable status. Careful patient selection is crucial to identify those most likely to benefit from this treatment.