CANTCAM project (ANaplastic Thyroid Carcinoma in CAstilla-La Mancha). Multicenter retrospective study

To analyze the clinical presentation, diagnosis, management and survival of Anaplastic Thyroid Carcinomas (ATC) in the Hospitals of Castilla-La Mancha (Spain).

Retrospective multicenter descriptive study. Adult patients with ATC diagnosed from 2002 to 2022 were included.

Of the 43 patients included, 53.5% were women, with a mean age of 72 years (SD 10) at the time of diagnosis. Symptoms were present in 100% of the patients and the most frequent symptom was a rapidly growing mass (79.1% of the cases). Infiltration of neighboring structures (76.7%), lymph node involvement (78.1%) and distant metastasis (51.2%). The AJCC-TNM category was IVa in 9.3%, IVb in 39.5% and IVc in 51.2%. BRAF^V600E determination was not performed in 74.4% and 5 of the 11 cases in which it was evaluated (45.4%) had the mutation. Active treatment was received in 76.7% of patients in the first 3 mo. Surgical approach was performed in 63.6% of the cases, with complete resection in 23.8%, and 51.5% received multimodality treatment in this period. 42.3% received active treatment during follow-up (≥ 3 mo), primarily systemic chemotherapy (72.7%), and 54.4% received multimodality treatment during this period. The median specific survival was 3.5 mo (95% CI 1.7-5.2). Factors associated with longer specific survival were initial multimodality treatment (p < 0.01) or during follow-up (p = 0.01) and initial BRAF/MEK inhibitor treatment (p = 0.04).

CAT is an infrequent and aggressive tumor that requires early, multidisciplinary, personalized and multimodal treatment.