Anaplastic thyroid cancer natural history, complications and prognosis

Depending on the extent of the tumor at the time of diagnosis, the prognosis of anaplastic thyroid cancer may vary. However, the prognosis is generally regarded as poor. The presence of metastasis is associated with a particularly poor prognosis among patients with anaplastic thyroid cancer.

Anaplastic thyroid cancer is very aggressive and can invade directly into adjacent organs, such as the trachea, larynx, esophagus, blood vessel and muscle, resulting in suffocation, vocal cord paralysis, dyspnea or dysphagia. Most patients die a few months after diagnosis because of uncontrolled neck mass and metastases, and long-term survivors are rare.^[1]

• Common complications of anaplastic thyroid cancer are:

• Dyspnea
• Metastasis
• Hoarseness of voice

• The overall 5-year survival rate of anaplastic thyroid cancer has been given as 7%^[2] or 14%,^[3] although the latter has been criticized as being overestimated. Death is attributable to upper airway obstruction and suffocation in half of patients, and to a combination of complications from either local and distant disease or therapy, or both in the remainder.^[4]
• Anaplastic thyroid cancer is extremely aggressive; in most cases death occurs in less than 1 year as a result of aggressive local growth and compromise of vital structures in the neck. Anaplastic thyroid cancer in most series has a median survival of 4 to 5 months from the time of diagnosis, with rare long-term survivors.^[5]

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