An audit of anaplastic carcinoma of thyroid from a single institution.

Abstract

e18084 Background: Anaplastic thyroid carcinoma (ATC) is a rare thyroid malignancy with a dire prognosis, nearly 100% disease specific mortality and a median overall survival of less than 6 months. In view of the limited data from India on anaplastic thyroid cancer we conducted this audit to analyze the treatment pattern, outcomes and factors influencing it. Methods: This is a retrospective analysis of outcomes of patients treated in a single institution between Jan 2008- Dec 2020. Baseline characteristics, treatment received and outcomes among adult patients with ATC were collected. Progression free survival (PFS) and Overall survival (OS) were analyzed. SPSS version 20 and R Studio version 3.1.1 were used for analysis. Results: In this cohort of 134 patients, the median age at diagnosis was 59 years, with 63.4% of them being females. At presentation, 70.9% of them had good performance status (PS 0-1). Only 38.8% received treatment with radical intent (either surgery f.b adjuvant or NACT f.b surgery f.b adjuvant or definitive CTRT) while 61.2% patients received palliative treatment (either palliation alone or palliative chemotherapy or palliative surgery or palliative RT). Predominant pattern of progression was local progression (79.8%). Median PFS and OS of the overall cohort was 58 days and 80 days respectively. PFS and OS was significantly better in patients treated with radical intent vs. palliative intent (116 and 134 days Vs 45 and 50 days; p = 0.00 and 0.00 respectively). Among patients treated with radical intent, OS was significantly better in patients undergoing surgery Vs CTRT (155 Vs 76days; p = 0.03). Among patients treated with upfront surgery, both PFS and OS were better with the addition of adjuvant CTRT/RT Vs no adjuvant (332 and 540 days vs 55 and 91 days; p = 0.00 and 0.003 respectively). Conclusions: ATC is a rare cancer with dismal prognosis. Local therapy with surgery followed adjuvant seems to be associated with the better outcomes. Systemic therapy seems to be a better option for palliation. However the outcomes are far from satisfactory and research is required for development of affordable therapies.