Background: Anaplastic thyroid carcinoma (ATC) is a rare and frequently fatal type of thyroid cancer. The degree of heterogeneity in survival rates for ATC is incompletely studied. This study evaluated the factors associated with overall survival (OS) of patients with ATC using multicenter real-world data from a national tertiary care center network in France. Methods: In this multicenter, retrospective cohort study, all patients with ATC diagnosed between 2010 and 2020 were identified from the national database of the French ENDOCAN-TUTHYREF network. Factors associated with OS were examined in multivariable analyses using Cox proportional hazards models. Results: The study included 360 patients. Of these, 220 (61%) were female and the median age was 72 years (interquartile range: 62-80). The percentages of patients with pure and mixed (synchronously-transformed) ATC (p-ATC and st-ATC) were 62.5% and 26.7%, respectively. The median OS was 6.8 months [confidence interval, CI: 5.5-8.1]: not reached for stage IVa, 11.4 months [8.2-17.8] for IVb, and 4.6 months [3.5-5.7] for IVc. Surgery, radiation therapy to the neck, chemotherapy, and best supportive care were administered to 69 (19.2%), 214 (59.4%), 254 (70.6%), and 66 (18.3%) patients, respectively. In a multivariable analysis, including stage IVb-IVc patients, significantly higher OS was observed in patients with Eastern Cooperative Oncology Group performance-status of 0-1 (hazard ratio [HR], 0.6; [CI, 0.4-0.9], p < 0.02), stage IVb [HR, 0.5; CI, 0.4-0.8, p < 0.001], and multimodal treatment (surgery and chemoradiotherapy) [HR, 0.07; CI, 0.04-0.1, p < 0.001]. Variables associated with significantly worse OS included: p-ATC (vs. st-ATC) [HR, 1.83; CI, 1.33-2.51, p = 0.001] and a neutrophil-to-lymphocyte ratio (NLR) >5.05 [HR, 2.05, CI, 1.39-3.05, p < 0.001]. Conclusions: Factors independently associated with improved OS in ATC included: European Cooperative Oncology Group performance status, disease stage, multimodality treatment, synchronously transformed ATC, and lower NLR. Long-term OS was observed in selected patients with ATC who underwent multimodal treatment.

中文翻译：

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与甲状腺未分化癌生存相关的因素：来自 ENDOCAN-TUTHYREF 网络的多中心研究。

背景：甲状腺未分化癌（ATC）是一种罕见且常常致命的甲状腺癌。ATC 存活率的异质性程度尚未完全研究。本研究使用来自法国国家三级护理中心网络的多中心真实世界数据评估了与 ATC 患者总生存 (OS) 相关的因素。方法：在这项多中心、回顾性队列研究中，从法国 ENDOCAN-TUTHYREF 网络国家数据库中识别出 2010 年至 2020 年间诊断的所有 ATC 患者。使用 Cox 比例风险模型通过多变量分析检查与 OS 相关的因素。结果：该研究纳入了 360 名患者。其中，220 名 (61%) 为女性，中位年龄为 72 岁（四分位距：62-80）。纯 ATC 和混合（同步转化）ATC（p-ATC 和 st-ATC）患者的百分比分别为 62.5% 和 26.7%。中位 OS 为 6.8 个月 [置信区间，CI：5.5-8.1]：IVa 期未达到，IVb 期为 11.4 个月 [8.2-17.8]，IVc 期为 4.6 个月 [3.5-5.7]。分别有 69 名（19.2%）、214 名（59.4%）、254 名（70.6%）和 66 名（18.3%）患者接受了手术、颈部放射治疗、化疗和最佳支持治疗。在包括 IVb-IVc 期患者在内的多变量分析中，东部肿瘤合作组表现状态为 0-1 的患者观察到 OS 显着升高（风险比 [HR]，0.6；[CI，0.4-0.9]，p < 0.02)，IVb 期 [HR，0.5；CI，0.4-0.8，p < 0.001] 和多模式治疗（手术和放化疗）[HR，0.07；CI，0.04-0.1，p < 0.001]。与 OS 明显较差相关的变量包括：p-ATC（与 st-ATC）[HR，1.83；CI，1.33-2.51，p = 0.001]，中性粒细胞与淋巴细胞比率 (NLR) > 5.05 [HR，2.05，CI，1.39-3.05，p < 0.001]。结论：与 ATC 改善 OS 独立相关的因素包括：欧洲肿瘤合作组表现状态、疾病分期、多模式治疗、同步转化 ATC 和较低的 NLR。在接受多模式治疗的选定 ATC 患者中观察到了长期 OS。