Anaplastic thyroid cancer: multimodal treatment results

Area of Science:

• Oncology
• Thyroid Cancer Research
• Surgical Oncology

Background:

• Anaplastic thyroid cancer (ATC) is a rare (1-2% of thyroid malignancies) but highly lethal endocrine malignancy.
• ATC is characterized by aggressive locoregional disease and high metastatic potential, with mortality exceeding 90%.
• Optimal treatment strategies for ATC remain controversial, necessitating analysis of outcomes in specific populations.

Purpose of the Study:

• To analyze treatment outcomes for anaplastic thyroid cancer in a mestizo population.
• To identify factors associated with improved survival in ATC patients.
• To evaluate the efficacy of different therapeutic modalities in managing this aggressive cancer.

Main Methods:

• Retrospective review of 1,581 thyroid carcinoma cases, identifying 29 (1.83%) with ATC.
• Analysis of demographic data, clinical presentation, tumor characteristics, and treatment regimens.
• Statistical evaluation of survival data in relation to treatment interventions.

Main Results:

• The median patient age was 64.5 years, with a female predominance (2.6:1 ratio).
• Common symptoms included neck enlargement (93.1%) and hoarseness (71.3%). Median tumor size was 8 cm.
• Complete resection (R0), radiation doses >33.1 Gy, and multimodal therapy (surgery + radiotherapy +/- systemic treatment) were associated with better survival (p=0.006). Median overall survival was 119 days.

Conclusions:

• Complete surgical resection, though challenging due to tumor aggressiveness, improves survival in ATC.
• Multimodal therapy offers survival benefits and enhances quality of life for ATC patients.
• The limited benefit of extensive surgery in invasive/metastatic disease underscores the critical need for novel systemic treatments.