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.

Lee JS, et al. Yonsei Med J. 2024 Jun;65(6):348-355. https://doi.org/10.3349/ymj.2023.0266

Background/Objectives: Anaplastic thyroid cancer (ATC) is an aggressive thyroid cancer subtype with a poor prognosis. The Controlling Nutritional Status (CONUT) score, reflecting both immune and nutritional status, is a prognostic marker in several malignancies; however, its utility in ATC has not been established. We aimed to evaluate the predictive value of the pretreatment CONUT score in ATC and compare its prognostic utility with that of other nutritional indices, including the Prognostic Nutritional Index (PNI) and Geriatric Nutritional Risk Index (GNRI). Methods: We retrospectively reviewed clinical characteristics, laboratory parameters, and survival outcomes of 156 patients with ATC at our institution between January 2004 and May 2024. Based on survival analysis, patients were categorized into low- and high-risk groups based on each nutritional index (CONUT score, PNI, GNRI) using optimal cut-off values. One-year survival differences were evaluated using Kaplan–Meier curves and log-rank test. Independent predictors of 1-year mortality were identified using multivariable Cox proportional hazards regression. Results: Optimal thresholds were 3, 42, and 102 for the CONUT score, PNI, and GNRI, respectively. Patients with CONUT scores ≥ 3 exhibited significantly higher 1-year mortality, compared with those with scores < 3. Multivariable analysis revealed that CONUT score ≥ 3, PNI ≤ 42, and GNRI ≤ 102 were independently associated with increased 1-year mortality risk. Incorporation of CONUT score ≥ 3 into the baseline prediction model significantly enhanced its discriminatory performance. Conclusions: These findings underscore the prognostic value of pretreatment immuno-nutritional assessment and support the integration of the CONUT score into early risk stratification strategies for patients with ATC.

Background/Objectives: The TOETVA and TORT have been successfully refined in recent years, with few complications and excellent results. In this study, we compared TORT and TOETVA in patients with papillary thyroid cancer. Methods: From September 2016 to January 2022, we retrospectively compared patient characteristics and clinical features from 100 TORT cases and 300 TOETVA cases, as well as their respective learning curves. Results: Median operation time of TORT was 80.4 min, similar to TOETVA (81.4 min, p = 0.719). Median docking time of TORT was 4.51 min and median console time was 27.72 min. The length of stay of TORT and TOETVA was 2.29 and 2.54 (p = 0.002). The median number of retrieved central lymph nodes for TOETVA and TORT were 2.89 and 2.99 (p = 0.746). Discussion: There was no significant difference with clinical features between TORT and TOETVA.

Background/Objectives: Anaplastic thyroid cancer (ATC) is an aggressive thyroid cancer subtype with a poor prognosis. The Controlling Nutritional Status (CONUT) score, reflecting both immune and nutritional status, is a prognostic marker in several malignancies; however, its utility in ATC has not been established. We aimed to evaluate the predictive value of the pretreatment CONUT score in ATC and compare its prognostic utility with that of other nutritional indices, including the Prognostic Nutritional Index (PNI) and Geriatric Nutritional Risk Index (GNRI). Methods: We retrospectively reviewed clinical characteristics, laboratory parameters, and survival outcomes of 156 patients with ATC at our institution between January 2004 and May 2024. Based on survival analysis, patients were categorized into low- and high-risk groups based on each nutritional index (CONUT score, PNI, GNRI) using optimal cut-off values. One-year survival differences were evaluated using Kaplan–Meier curves and log-rank test. Independent predictors of 1-year mortality were identified using multivariable Cox proportional hazards regression. Results: Optimal thresholds were 3, 42, and 102 for the CONUT score, PNI, and GNRI, respectively. Patients with CONUT scores ≥3 exhibited significantly higher 1-year mortality, compared with those with scores <3. Multivariable analysis revealed that CONUT score ≥3, PNI ≤42, and GNRI ≤102 were independently associated with increased 1-year mortality risk. Incorporation of CONUT score ≥3 into the baseline prediction model significantly enhanced its discriminatory performance. Conclusions: These findings underscore the prognostic value of pretreatment immuno-nutritional assessment and support the integration of the CONUT score into early risk stratification strategies for patients with ATC.

Kim NK, et al. J Endocr Surg. 2025 Jun;25(2):66-77. https://doi.org/10.16956/jes.2025.25.2.66