Endocrine Abstracts

Introduction: Anaplastic thyroid cancer is a devastating disease with median survival between 1.2 and 10 months. The disease accounts for as little as 0.9–1.6% of total thyroid cancer cases, but may account for up to half of all thyroid cancer mortality. The aim of our study is to evaluate the prognostic factors and outcomes of patients diagnosed with anaplastic thyroid cancer in Ireland and review emerging treatments for this disease.

Methods and design: A retrospective analysis of the National Cancer Registry in Ireland was undertaken, for patients with a diagnosis of anaplastic thyroid cancer between 2000 and 2010. Patient, tumour, and treatment characteristics were recorded. The Kaplan–Meier method was used to determine overall survival and factors predictive of outcome were determined by univariate and multivariate analysis by cox regression using Stata 13 software.

Results: Of a total of 64 patients, 40 were female and 24 were male. The median age was 69, and 27.5% of patients had distant metastases at diagnosis. The overall median survival was 2.3 and the 6 months, 1, 2, and 5 year overall survival was 23.4, 12.5, 6.25, and 4.69% respectively. On univariate analysis age, gender, metastases at diagnosis, surgery, radiotherapy, and multimodality treatment were statistically significant indicators of prognosis, and metastases at diagnosis remained statistically significant on multivariate analysis. A review of the7741 patients in the literature revealed a median survival of 3.67 months.

Conclusions: The British and American Thyroid associations (BTA/ATA) have comprehensive guidelines on the management of ATC. However due to the rapidity of onset of the tumour, few patients benefit substantially from aggressive conventional treatments, and survival has not changed over a period of 40 years. Personalised therapeutic approaches based on the use of targeted therapy may be the best hope to improve treatments for patients with ATC.