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Combined surgical and radiation therapy may be of benefit in patients with anaplastic carcinoma of the thyroid

(July 2005)

The background of the study. Patients with anaplastic thyroid carcinomas have a very poor prognosis, and few survive for more than a year after diagnosis. This study was done to describe the manifestations and outcome in a large cohort of patients with this tumor.

How the study was done. The study subjects were all patients with anaplastic thyroid carcinoma seen at hospitals in the states and metropolitan regions of the United States that constitute the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute between 1973 and 2000. The diagnosis was confirmed by pathological examination of the tumor.

The results of the study. During the 27-year period, 516 patients (345 women, 171 men; average age, 71 years) with anaplastic carcinoma were reported to the program. The average tumor size was 6 cm (range, 1 to 15). The tumor was confined to the thyroid gland in 7 percent, was locally invasive or involved cervical lymph nodes in 38 percent, and had spread to distant sites in 43 percent; the stage was not reported for 12 percent. Some thyroid surgery was done in 49 percent, and 63 percent received radiation therapy.

The cancer-related death rate was 69 percent at 6 months and 81 percent at 12 months. The only statistically significant predictors of a better prognosis were younger age, lesser extent of disease, and combined surgical and external radiation therapy.

The conclusions of the study. Anaplastic thyroid carcinoma is usually rapidly fatal; younger age, limited extent of tumor, and combined surgical and external radiation therapy are associated with a slightly better prognosis.

The original article. Kebebew E, Greenspan FS, Clark OH, Woeber KA, McMillan A. Anaplastic thyroid carcinoma: treatment outcome and prognostic factors. Cancer 2005;103:1330-5.