Author(s)
Christopher Hatzis BA
Roman Povolotskiy BA
Meghan Crippen MS
Jean Eloy MD
Soly Baredes MD
Richard Park MD
Affiliation(s)
Rutgers New Jersey Medical School
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to assess the impact of treatment type on survival with anaplastic thyroid carcinoma. Objectives: To investigate the impact of patient characteristics and treatment type on survival with anaplastic thyroid carcinoma. Study Design: Retrospective analysis of a population based tumor registry. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was queried for cases of anaplastic carcinoma of the thyroid gland from 1983-2013 (1260 cases). Demographics, clinicopathologic features, treatment modalities, and survival rates were analyzed. Of the 1260 cases, 1050 were included in the survival analysis. Kaplan Meier testing for disease specific survival was assessed at 6, 12, and 18 months. For each treatment type, log-rank significance and Cox hazard regression proportions were generated. Results: Overall survival was 30.2% at 6 months, 17.9% at 12 months, and 14.6% at 18 months. Female gender, increased age, unmarried marital status, tumor stage (T4b), regional lymph node involvement, and distant metastasis at diagnosis were each correlated with significantly worse disease specific survival at all time points. Patients receiving radiation alone survived an additional 4.2 months (p=0.002), those receiving surgery alone survived an additional 6.59 months (p=0.002), and those receiving combination therapy survived an additional 18.47 months (p<0.001). After accounting for confounding factors via multivariate analysis the following groups had a significantly lower risk of death, including: radiation only group (OR:0.582[0.420-0.806]p=0.001), surgery only group (OR:0.653[0.457-0.933]p=0.019), and combination (radiation and surgery) therapy group (OR:0.247[0.163-0.374]p<0.001). Conclusions: Anaplastic thyroid carcinoma is a morbid disease with high rates of death due to disease within the first year. Treatment, when appropriate, is correlated with improved survival after controlling for significant demographic and clinicopathologic factors.