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Updated: Aug 11, 2025
Spontaneous Murine Model of Anaplastic Thyroid Cancer
Published on: February 3, 2023
Association of Treatment Strategies and Tumor Characteristics With Overall Survival Among Patients With Anaplastic
Shannon S Wu1, Eric D Lamarre2, Anirudh Yalamanchali3
1Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
Importance:
Survival outcomes for anaplastic thyroid cancer (ATC), the most aggressive subtype of thyroid cancers, have remained poor. However, targeted therapies and immunotherapies present new opportunities for treatment of this disease. Evaluations of survival outcomes over time with new multimodal therapies are needed for optimizing treatment plans.
Objective:
To evaluate the association of treatment strategies and tumor characteristics with overall survival (OS) among patients with ATC.
Design, Setting, And Participants:
This retrospective case series study evaluated the survival outcomes stratified by treatment strategies and tumor characteristics among patients with ATC treated at a tertiary level academic institution from January 1, 2000, to December 31, 2021. Demographic, tumor, treatment, and outcome characteristics were analyzed. Kaplan-Meier method and log rank test modeled OS by treatment type and tumor characteristics. Data were analyzed in May 2022.
Main Outcomes And Measures:
Overall survival (OS).
Results:
The study cohort comprised 97 patients with biopsy-proven ATC (median [range] age at diagnosis, 70 [38-93] years; 60 (62%) female and 85 [88%] White individuals; 59 [61%] never smokers). At ATC diagnosis, 18 (19%) patients had stage IVA, 19 (20%) had stage IVB, and 53 (55%) had stage IVC disease. BRAF status was assessed in 38 patients; 18 (47%) had BRAF-V600E variations and 20 (53%), BRAF wild type. Treatment during clinical course included surgery for 44 (45%) patients; chemotherapy, 41 (43%); definitive or adjuvant radiation therapy, 34 (RT; 35%); and targeted therapy, 28 (29%). Median OS for the total cohort was 6.5 (95% CI, 4.3-10.0) months. Inferior OS was found in patients who did not receive surgery (hazard ratio [HR], 2.12; 95% CI, 1.35-3.34; reference, received surgery), chemotherapy (HR, 3.28; 95% CI, 1.99-5.39; reference, received chemotherapy), and definitive or adjuvant RT (HR, 2.47; 95% CI, 1.52-4.02; reference, received definitive/adjuvant RT). On multivariable analysis, age at diagnosis (HR, 1.03; 95% CI, 1.01-1.06), tumor stage IVC (HR, 2.65; 95% CI, 1.35-5.18), and absence of definitive or adjuvant RT (HR, 1.90; 95% CI, 1.01-3.59) were associated with worse OS.
Conclusions And Relevance:
This retrospective single-institution study found that lower tumor stage, younger age, and the ability to receive definitive or adjuvant RT were associated with improved OS in patients with ATC.
Insights
Anaplastic thyroid cancer (ATC) survival is poor, but younger age, lower stage, and receiving radiation therapy improve outcomes. These factors are crucial for optimizing treatment plans for aggressive thyroid cancer.
Area of Science:
- Oncology
- Thyroid Cancer Research
- Cancer Treatment Strategies
Background:
- Anaplastic thyroid cancer (ATC) is an aggressive subtype with historically poor survival outcomes.
- Emerging targeted therapies and immunotherapies offer new treatment avenues.
- Evaluating survival trends with multimodal therapies is essential for treatment optimization.
Purpose of the Study:
- To investigate the association between treatment strategies, tumor characteristics, and overall survival (OS) in patients with ATC.
- To identify prognostic factors influencing survival in ATC patients.
Main Methods:
- Retrospective case series of 97 patients with biopsy-proven ATC (2000-2021).
- Analysis of demographic, tumor, treatment, and outcome data.
- Kaplan-Meier method and log-rank tests used to model OS based on treatment and tumor characteristics.
Main Results:
- Median OS for the cohort was 6.5 months.
- Patients not receiving surgery, chemotherapy, or definitive/adjuvant radiation therapy had inferior OS.
- Multivariable analysis indicated that older age at diagnosis, stage IVC disease, and absence of definitive/adjuvant RT were associated with worse OS.
Conclusions:
- Lower tumor stage, younger age at diagnosis, and receipt of definitive or adjuvant radiation therapy are associated with improved overall survival in ATC patients.
- These findings highlight the importance of multimodal treatment approaches and early intervention for improving ATC prognosis.
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