OBJECTIVETo summarize the new knowledge of the anaplastic thyroid carcinoma (ATC).

METHODSThe clinical data of 58 patients (35 men, 23 women, aged 28 to 79 years) with ATC that were treated with various therapeutic modalities from 1981 to 2005 were retrospectively analyzed. Among them, 25 patients received surgery alone (SA group) and 33 received surgery plus radiation (S + R group). The dosage of postoperative radiotherapy was 40-70 Gy. Four patients received biopsy, 24 received palliative surgery, and 30 received radical surgery. Only 2 patients received complete chemotherapy.

RESULTSATC invaded trachea in 40 patients (69.0%), esophagus in 32 patients (55.2%), and carotid in 17 patients (29.3%). The cervical lymph node metastases occurred in 19 patients (32.8%). The overall 1-year survival rate was 37.8%, 3-year survival rate 31.2%, and 5-year survival rate 25.9%. The 5-year survival rate was 37.8% in S + R group but was only 9.9% in SA group (P = 0.0000). The 5-year survival rate was 41.4% in radical surgery subgroup but was only 12.4% in palliative surgery subgroup (P = 0.0023). In < or = 45-year-old subgroup (n = 4), the 5-year survival rate was 50.0%; however, in > 45-year-old subgroup, it was only 21.3%. In postoperative radiation < 60 Gy subgroup , the 5-year survival rate was 19.3%; however, in > or = 60 Gy group, it was 53.7% (P = 0.0000). Among all the 58 patients, some patients received palliative surgery because of tumor invasion in trachea (n = 16, 27.6%), esophagus (n = 8, 13.8%), carotid (n = 8, 13.8%), and other sites (n = 13, 22.4%). Twenty-four patients (61.5%) died of localrelapse, 2 (5.1%) of cervical lymphnode failure, 9 (23.1%) of metastasis, and 4 (10.3%) of other reasons.

CONCLUSIONSThe prognosis of ATC is poor. Radical surgery and postoperative radiation > or = 60 Gy can improve the survival rate. Tumor invasion in trachea, esophagus, and carotid are the main reasons of palliative surgery. Local relapse is lethal.