Anaplastic thyroid carcinoma: palliation or treatment?

To review the recent published literature on the topic of anaplastic thyroid carcinoma and discern if significant advances have occurred that alter the historically poor prognosis associated with this diagnosis.

Surgical resection for patients with stage IVA disease (intra-thyroidal without extracapsular extension) with postoperative chemoradiation remains the standard recommendation. Care for patients with stage IVB disease, extrathyroidal spread without distant metastases, remains varied and controversial. Research into different molecular therapies (deacetylase inhibitors, tubulin binding compounds, etc.) and the pathogenesis of anaplastic carcinoma continues to evolve. Care for patients with metastatic disease, stage IVC, is focused on quality of life.

Although occasional reports exist of long-term survivors with anaplastic thyroid carcinoma, the prognosis remains poor. Accurate staging is critical to offering the most appropriate treatment. Multimodality treatment is required if prolonged locoregional control or survival is desired.