Survival Benefit of Intervention Treatment in Advanced Anaplastic Thyroid Cancer

Abstract Background Management of anaplastic thyroid cancer (ATC) is a controversial issue; thus, proper treatment and prognostic factors should be investigated. Objectives To compare the survival outcomes of intervention and palliative treatment in ATC patients. Methods A hospital-based retrospective study was conducted in a single tertiary university hospital. The medical record charts were retrieved from November 20, 1987 to December 31, 2016. The final follow-up was ended by December 31, 2017. Patients’ demographic data, laboratory data, clinical presentation, and results of treatment modalities were analyzed. Results One hundred twenty-one records were analyzed that one-year overall survival rate of 3.5% (median survival time of 77 days); however, there was insufficient data on 16 cases to classify staging and treatment modalities. Therefore 105 ATC patients (37 stage IVa, 39 stage IVb, 29 stage IVc) were included with one-year overall survival rate of 4.0% (median survival time of 82 days). Intervention treatment allowed longer median survival times (p < 0.05) and a better survival rate (p < 0.05). Among the intervention treatment group, post-operative chemoradiation yielded the longest median survival time (187 days) and the longest survival rate (20%) (p < 0.05). At all stages, intervention modality allowed better median survival time, especially in stage IVa (p < 0.05). Unfavorable prognostic factors were adjusted with multiple cox regression model that showed significant factors included age ≥ 65 years (HR of 2.57), palliative treatment (HR of 1.85), and leukocytosis ≥ 10,000/mm3(HR of 2.76). Conclusions Intervention treatment provided a better survival outcome in all stages, especially in stage IVa with a significantly better median survival time. Among intervention treatments, postoperative chemoradiation offered the longest survival rate; thus, suggesting this should be considered in ATC patients who have resectable tumors and no poor prognostic factors such as older age and leukocytosis.