title: Anaplastic thyroid carcinoma: a 25-year single-institution experience.
abstract: BACKGROUND
  Anaplastic thyroid carcinoma (ATC) is among the most aggressive solid tumors accounting for 1-5 % of primary thyroid malignancies. In this retrospective review, we aim to evaluate the prognostic factors, treatment approaches, and outcomes of patients with ATC treated at a single institution.
  
  
  METHODS
  We retrospectively identified 95 patients with ATC from an institutional database between 1985 and 2010. A total of 83 patients with sufficient records were included in this study. Patient, tumor, and treatment characteristics were recorded. Disease-specific survival (DSS) was determined by the Kaplan-Meier method, and factors predictive of outcome were determined by univariate and multivariate analysis.
  
  
  RESULTS
  Of the 83 patients, 41 were male and 42 were female. The median age at presentation was 60 years (range 28-89 years) with a median survival of 8 months. The 1- and 2-year DSS were 33 and 23 %, respectively. On univariate analysis, age less than 60 years, clinically N0 neck, absence of clinical extrathyroidal extension (cETE), gross total resection, and multimodality treatment were statistically significant predictors of improved survival. On multivariate analysis, absence of cETE, multimodality therapy, and gross total resection were predictors of improved outcome.
  
  
  CONCLUSIONS
  In patients with locoregional limited disease, multimodality treatment with gross total surgical resection and postoperative radiotherapy with or without chemotherapy offers the best local control and DSS.
authors.affiliation: Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: A
authors.initials: A
authors.lastname: Mohebati
authors.forename: M
authors.initials: M
authors.lastname: Dilorenzo
authors.forename: F
authors.initials: F
authors.lastname: Palmer
authors.forename: S G
authors.initials: SG
authors.lastname: Patel
authors.forename: D
authors.initials: D
authors.lastname: Pfister
authors.forename: N
authors.initials: N
authors.lastname: Lee
authors.forename: R M
authors.initials: RM
authors.lastname: Tuttle
authors.forename: A R
authors.initials: AR
authors.lastname: Shaha
authors.forename: J P
authors.initials: JP
authors.lastname: Shah
authors.forename: I
authors.initials: I
authors.lastname: Ganly
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011878:Radiotherapy; D012189:Retrospective Studies; D015996:Survival Rate; D065646:Thyroid Carcinoma, Anaplastic / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D013965:Thyroidectomy