Survival analyses
METASTASES, LYMPH NODE METASTASES
The median overall survival (OS) was 6 months and 30% lived longer than one year (Table Univariate survival analysis using Kaplan–Meier-curves and Cox proportional hazard modelsBold values identify significant results with p ≤0.05 = statitical significant, CI= Confidence Interval, R0 = Complete resection with clear margins, R1 = Resection with positive microscopic margins, R2 = Resection with positive macroscopic margins,RT = Radiotherapy, CTx = ChemotherapyOverall survival for all patients with ATC (n = 63)Overall survival for: Patients without distant metastases had a median OS of 8 months compared to the median OS of 4 months in patients with metastases.When any kind of surgery was performed, an extension of OS from 3.6 to 9.8 months was observed, although it is questionable whether this was an effect of the surgery itself or of selection. If resection status R0 (clear margins) was reached, OS was better (14 months for R0 compared to 6 months for R +).The median survival time for patients who received a total radiation dose of 50 Gy or higher was 13 months, versus 2.5 months in the comparison group (< 50 Gy).In addition, a multimodal therapy consisting of surgery, radiotherapy and chemotherapy was associated with longer survival (9.8 months), compared to the use of only one or two therapy modalities. The median survival for use of surgery plus radiotherapy was 6 months, for radiation plus chemotherapy 4 months and for only radiotherapy 3 months.Chemotherapy or concurrent radiochemotherapy had no significant effect on survival time, neither for patients with M0, nor for cases without metastases at the time of diagnosis. Likewise, absence of lymph node metastases, lymph node dissection, radiation delivery technique (IMRT or VMAT vs. 3D-konformal/opposing field technique) or histological differences (ATC vs. ATC + DTC) could not show any significant effect on OS.There was no significant difference in overall survival depending on the year of diagnosis (Table Overall survival for patients diagnosed until 2008 (older study) versus since 2008 (recent study)