ANAPLASTIC CARCINOMA OF THE THYROID - A 24-YEAR EXPERIENCE

Background. Anaplastic carcinoma of the thyroid gland is a lethal enti ty; few patients live more than 12 months following diagnosis. We retr ospectively reviewed the experience with this entity at our cancer ins titute and identified a subgroup of patients with complete resection w ho have a 60% 5-year survival.Methods. Twenty-one cases of anaplastic carcinoma of the thyroid gland were analyzed retrospectively with resp ect to prognostic factors influencing survival. This represents 2.7% o f 771 cases of thyroid cancer seen at our institution from 1968 to 199 2. The median age at presentation was 65.1 years; male/female ratio wa s 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 compl ete resection had an estimated 5-year survival of 60% (median: 131 mon ths). Four of these patients had postoperative radiotherapy with or wi thout sequential chemotherapy. Two of these patients survived more tha n 10 years, and a third remains alive without disease at 26 months. Co nclusions. Complete resection and multimodality therapy result in long -term survival for a subgroup of patients with anaplastic thyroid carc inoma. (C) 1995 John Wiley & Sons, Inc.