Primary squamous cell carcinomas in the thyroid gland: an individual participant data meta‐analysis

• Published in: Cancer medicine (Malden, MA) MA), 2014-10, Vol.3 (5), p.1396-1403
• Main Authors: Cho, Jae Keun, Woo, Seung‐Hoon, Park, Junoh, Kim, Min‐Ji, Jeong, Han‐Sin
• Format: Article
• Language: English
• Subjects: Adult; Age; Aged; Aged, 80 and over; Biopsy; Cancer Prevention; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - therapy; Chemotherapy; Diagnosis; Disease; Dysphagia; Dyspnea; Eradication; Female; Frailty; Gender; Humans; Literature reviews; Lymphatic system; Male; Medical prognosis; Medical records; Meta-analysis; Metastasis; Middle Aged; outcomes; Patients; Prognosis; Radiation therapy; Rare diseases; Respiration; Squamous cell carcinoma; squamous cell carcinomas; Studies; Surgery; Systematic review; Thyroid cancer; Thyroid carcinoma; Thyroid gland; Thyroid Neoplasms - diagnosis; Thyroid Neoplasms - mortality; Thyroid Neoplasms - therapy; treatment; Treatment Outcome; Tumors; Variables; Young Adult
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.287

Primary squamous cell carcinomas arising from the thyroid gland (SCCTh) is extremely rare diseases, which have never been fully studied. Thus, we performed a systematic review and individual participant data meta‐analysis of published SCCTh cases, to understand the clinical characteristics and to identify the prognostic factors of primary SCCTh. A literature search was conducted within Medline, EMBASE, Cochrane library databases and KoreaMed using the following Medical Subject Headings (MeSH) keywords: “primary,” “squamous,” “carcinoma,” “cancer,” and “thyroid.” Eighty‐four patients' individual data from 39 articles and five patients' data in our institute were selected for analysis (N = 89). The mean age at diagnosis was 63.0 years (range, 24–90) and female preponderance (M:F = 1:2) was noted. The commonest complaint was the anterior neck mass, followed by dyspnea or dysphagia, and extension to the adjacent structure was found in 72%. The median survival was 9.0 months (95% CI, 6.0–23.0) and 3‐year survival rate (3YSR) was 37.6% by Kaplan–Meier method, but only 20.1% by a shared frailty model for adjusting heterogeneity. Complete resection (R0) of tumors was the only significant prognostic factor in multivariable analysis, and the benefit of adjuvant treatment was not proved. The prognosis of patients with SCCTh is very poor (20% in 3YSR), but complete resection of disease is correlated with improved survival. To achieve complete surgical eradication of tumors, early detection and accurate diagnosis should be emphasized. To better understand the clinical characteristics of primary thyroid squamous cell carcinomas and to identify the prognostic factors, we performed a systematic review and individual participant data meta‐analysis. The survival of these patients was ~20% in 3 years, but complete resection of disease correlated with improved survival.