Cancer history does not affect survival odds for adults with anaplastic thyroid carcinoma
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Overall survival rates for adults diagnosed with anaplastic thyroid carcinoma are similar between those with a history of cancer and those with no previous cancer diagnosis, according to findings published in Thyroid.
“Anaplastic thyroid cancer patients with prior histories of other cancers have similar survival outcomes as patients without a prior cancer history,” Jennifer Rui Wang, MD, assistant professor in the department of head and neck surgery at The University of Texas MD Anderson Cancer Center, told Healio. “As such, patients with prior cancer histories should not be excluded from clinical trials and multimodality treatment, which are important determinants of outcome in this aggressive disease.”
Wang and colleagues conducted a retrospective cohort study of patients who received a pathologic diagnosis for anaplastic thyroid carcinoma at MD Anderson Cancer Center from February 2000 to March 2019. Prior cancer history was obtained through electronic medical records. Prior thyroid cancer included papillary thyroid carcinoma, follicular thyroid carcinoma, poorly differentiated thyroid carcinoma and oncocytic thyroid carcinoma diagnosed more than 6 months before the anaplastic thyroid carcinoma diagnosis. All other prior cancers were included if a diagnosis was reported more than 1 month before the anaplastic thyroid carcinoma diagnosis. Overall survival was the primary outcome and defined as the time from date of anaplastic thyroid carcinoma diagnosis to date of death. The last date of follow-up was the date of death or the final follow-up appointment for patients still alive at the end of the study period.
The study included 451 adults diagnosed with anaplastic thyroid carcinoma (median age at diagnosis, 66 years). Median overall survival after diagnosis was 8.4 months, with 39% of the cohort alive 1 year after diagnosis and 22% alive 2 years after diagnosis.
Of the cohort, 14% had a history of prior thyroid cancer, with papillary thyroid carcinoma the most common type. Of those with prior thyroid cancer, 81% had distant metastasis at the time of anaplastic thyroid carcinoma diagnosis. Concomitant differentiated thyroid cancer was present in 52% of the full cohort at anaplastic thyroid carcinoma diagnosis. About 3% of patients had a history of both thyroid cancer and nonthyroid cancer at diagnosis.
Of those diagnosed with anaplastic thyroid carcinoma, 23% had a history of nonthyroid cancer at diagnosis. The most common prior cancer was nonmelanoma skin cancer. Among women, breast cancer was the most common prior cancer, whereas prostate cancer was most common among men. Prior nonthyroid cancer did not affect treatment regimens for anaplastic thyroid carcinoma.
In multivariable regression analysis, prior thyroid cancer and concomitant thyroid cancer did not affect the likelihood for overall survival. Similarly, adults with prior nonthyroid cancer had a similar overall survival as those with no cancer history. The number of prior cancers and history of radiation treatment also did not affect overall survival from anaplastic thyroid carcinoma.
“Even though we examined a limited subset of patients with molecular data, further research needs to be performed to determine whether genetic predisposition plays a role in the development of anaplastic thyroid cancer in relation to other nonthyroid cancers,” Wang said.
For more information:
Jennifer Rui Wang, MD, can be reached at jrwang@mdanderson.org.
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