title: Anaplastic thyroid cancer.
abstract: OBJECTIVE
  Anaplastic thyroid cancer (ATC) is a lethal disease causing a global disproportionate number of thyroid cancer-related deaths. The American Thyroid Association (ATA) has recently produced clear and comprehensive guidelines to assist physicians treating ATC.
  
  
  METHODS
  The recent ATA guideline publication was reviewed. A systematic review of studies indexed in Medline and Pubmed was also undertaken using search terms relevant to ATC.
  
  
  RESULTS
  Patients with ATC have a median survival of 5 months and less than 20% survive 1 year. Early tumor dissemination results in 20-50% percent of patients having distant metastases and 90% having adjacent tissue invasion on presentation. This highlights the necessity for effective combined therapy. Stage IVA/ IVB, resectable disease may benefit from a multimodal (surgery, IMRT for loco regional control, and systemic therapy) approach. However, a majority of patients present with unresectable locoregional disease. Early palliative care involvement is inclusive of life-prolonging therapies. ATC management demands rapid, complex and integrated multidisciplinary decision making.
  
  
  CONCLUSIONS
  In this article we discuss the multidisciplinary strategies that exist to optimize the management of these patients in accordance with the recent guidelines from The American Thyroid Association.
authors.affiliation: Otolaryngology, Head and Neck Surgery, The Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin, Ireland. joneill@rcsi.ie
authors.forename: James Paul
authors.initials: JP
authors.lastname: O'Neill
authors.forename: Ashok R
authors.initials: AR
authors.lastname: Shaha
mesh_terms: D058109:Airway Management; D003131:Combined Modality Therapy; D006801:Humans; D065646:Thyroid Carcinoma, Anaplastic; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy