Prognosis of Anaplastic Thyroid Cancer with Distant Metastasis

Simple Summary Anaplastic thyroid cancer (ATC) with distant metastasis is an extremely rare disease with a high mortality risk. This study aimed to exhibit the clinical characteristics of ATC with distant metastasis. Among the 152 patients with ATC, 88 (58%) had distant metastasis at the time of diagnosis. In the case of brain metastasis, 17 patients (11%) were included. ATC with distant metastasis has a poor prognosis regarding overall survival. Among the ATC cases, 11% had brain metastasis; thus, brain MRI or CT is worth considering at diagnosis and follow-up, even in patients without neurologic symptoms. Anaplastic thyroid cancer (ATC) is derived from follicular thyroid cells and is associated with high mortality risk. Obtaining information to characterize ATC is difficult because ATC with distant metastasis is extremely rare. This study determined the clinical characteristics of ATC with distant metastasis. The medical records of 152 patients with ATC at Gangnam Severance Hospital were reviewed between January 2004 and March 2022. The primary endpoint was the overall survival of the total patient sample, patients with ATC and distant metastasis, and those with ATC and brain metastasis. Of the 152 patients with ATC, 88 had distant metastasis at diagnosis. The 5-year disease-specific survival was 24% for total ATC and 10% for ATC with distant metastasis. Survival for >1 year was 32% for total ATC and 15% for ATC with distant metastasis. The median survival rate differed significantly between the total ATC and ATC with distant metastasis groups (228.5 vs. 171 days). Among the ATC cases, 11% had brain metastasis; thus, brain MRI or CT is worth considering at diagnosis and follow-up, even if there were no statistical difference in overall survival between patients with ATC with and without brain metastasis.