The prognosis of thyroid anaplastic carcinoma is poor. Yet can prognosis criteria change the therapeutic options?
Method: From a series of 26 cases from a single group recorded between 1990 and 2006, we analyzed the outcome after treatment based on surgery, radio and chemotherapy and looked for prognosis criteria.
Results: All but one patients died with a mean survival of 273 days (median survival of 130 days). Over 50% of patients had died within 6 months, and 80% within 12 months. Most deaths are related to loco regional tumour progression (n=15), but general dissemination (6) and drug toxicity (2) are also responsible.
Increased age, poor general condition at admission, rapid tumour growth (evaluated by pre-diagnosis duration of symptoms), compressive tracheal or oesophageal symptoms, and metastasis are associated with poorer prognosis while the concomitant presence of another histological thyroid carcinoma seems of better outcome.
Treatment can also influence the prognosis: complete surgery (563 vs 123 days) and multimodal treatment improve survival.
Conclusion: Despite poor overall prognosis, accurate evaluation of TAC at diagnosis is needed to evaluate outcome. Intensive treatment should always be applied.