Anaplastic thyroid cancer in British Columbia 1985-1999: a population-based study

To review the outcome of patients diagnosed with anaplastic thyroid carcinoma in British Columbia between January 1985 and December 1999.

Seventy-five patients were identified. Survival curves were calculated using Kaplan-Meier estimates, and the charts of the 62 patients referred to a British Columbia Cancer Agency (BCCA) facility were reviewed.

All cases: 51 out of 75 patients (68%) were women; median age of all patients was 74 years. The overall- and cancer-specific 5-year survival rates for the whole group were 5%. non-referred cases: nine out of 13 patients were women; median age at diagnosis 84 years. Eleven of the 13 patients died within 1 month of diagnosis. Referred cases: 42 out of 62 patients were women; median age 72 years; median survival 5.1 months; 1-year survival 19%. Forty-eight patients presented with tumours that extended through the thyroid capsule, 10 presented with distant metastases. Four patients had a total thyroidectomy, nine a partial thyroidectomy, and 49 a biopsy only. Fifty-seven patients received radiotherapy, nine of these had concurrent chemotherapy: Thirty-three patients received less than 40 Gy and 24 patients received 40 Gy or more. Median survival was longer (9 vs 3 months) in patients receiving 40 Gy or more; this group included four patients who had prolonged survival.

Long-term, disease-free survival was achieved in a few patients who were able to receive high-dose radiotherapy, preferably after adequate surgery.