Anaplastic carcinoma of the thyroid: A 24-year experience

Background. Anaplastic carcinoma of the thyroid gland is a lethal entity; few patients live more than 12 months following diagnosis. We retrospectively reviewed the experience with this entity at our cancer institute and identified a subgroup of patients with complete resection who have a 60% 5‐year survival. Methods. Twenty‐one cases of anaplastic carcinoma of the thyroid gland were analyzed retorspectively with respect to prognostic factors influencing survival. This represents 2.7% of 771 cases of thyroid cancer seen at our institution from 1968 to 1992. The median age at presentation was 65.1 years; male/female ratio was 1:1.1; and the most common symptom was a rapidly enlarging neck mass (76%). Results. Estimated 5‐year survival was 10% (median: 4.5 months). Tumor size less than 6.0 cm (p = .004) and female gender (p = .02) were significant prognostic factors. Five patients who underwent complete resection had an estimated 5‐year survival of 60% (median: 131 months). Four of these patients had postoperative radiotherapy with or without sequential chemotherapy. Two of these patients survived more than 10 years, and a third remains alive without disease at 26 months. Conclusions. Complete resection and multimodality therapy result in long‐term survival for a subgroup of patients with anaplastic thyroid carcinoma. © 1995 Jons Wiley & Sons, Inc.