An 8-year single-institution review of demograhics and treatment trends in anaplastic thyroid carcinoma

Background: Anaplastic thyroid carcinoma (ATC) is a rare entity with dismal overall survival (OS) of <6 months. Historically, patients are older (70 years) with poor performance status. This retrospective study analyzed the contemporary demographics and survival outcomes of ATC patients referred to the University of North Carolina between 2016 and 2024. Methods: Demographic, clinical, molecular, and survival data were extracted. Statistical analysis, including Kaplan–Meier survival estimates, were generated with Stata. Results: Of 49 ATC cases, patients were White (63%), male (51%), and never smokers (59%), with a median age of 71 and a median Eastern Cooperative Oncology Group (ECOG) performance score of 1. Forty patients (82%) received any treatment, including surgery (59%), radiotherapy (71%), and systemic therapy (71%). The one-year overall survival rate was 52% (definitive/curative intent), 36% (palliative intent), and 0% (no treatment/hospice). Between 2016-2019 and 2020-2024, the ATC patients at our institution doubled (14 vs. 35, respectively). Notable demographic shifts over those periods included increased non-White race (29% vs. 40%), male gender (43% vs. 54%), and younger age (73 vs. 71 years), respectively. Additionally, patients were more likely to initiate treatment, including increased surgery (43% vs. 66%) and systemic therapies (50% vs. 80%). Younger patients (<65 vs. ≥65 years) had longer median OS (384 vs. 151 days). Conclusions: Our single-institutional experience reveals an increase in ATC patients seen, shifting demographics, and changes in treatment practices over time. The availability of genomic testing and more effective therapies highlights the need to consider aggressive multimodal treatment in all patients, particularly those with good performance status.