{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T19:06:31Z","timestamp":1757617591780,"version":"3.44.0"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["R25DC020151"],"award-info":[{"award-number":["R25DC020151"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Anaplastic thyroid cancer (<jats:styled-content style=\"fixed-case\">ATC<\/jats:styled-content>) is an aggressive and potentially fatal thyroid malignancy. Clinical guidelines recommend that all <jats:styled-content style=\"fixed-case\">ATC<\/jats:styled-content> patients be evaluated by a multidisciplinary team, including palliative care specialists, with treatment decisions reflecting patients' evolving goals of care (<jats:styled-content style=\"fixed-case\">GOC<\/jats:styled-content>). This study aimed to investigate patterns of palliative care referrals and <jats:styled-content style=\"fixed-case\">GOC<\/jats:styled-content> documentation in advanced <jats:styled-content style=\"fixed-case\">ATC<\/jats:styled-content> patients treated with newer targeted therapies and immunotherapies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohort study of 58 <jats:styled-content style=\"fixed-case\">ATC<\/jats:styled-content> patients diagnosed between 2000 and 2023 at a single quaternary medical center. Data on demographics, treatments, palliative care referrals, and <jats:styled-content style=\"fixed-case\">GOC<\/jats:styled-content> discussions were collected by chart review and analyzed using Fisher's exact test, Wilcoxon rank\u2010sum tests, Kaplan\u2013Meier survival analysis, and multivariate logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean age at diagnosis was 69.2\u2009years, with 50% female. A minority of patients were referred to palliative care a median of 45\u2009days before death. Only 36.2% had a documented <jats:styled-content style=\"fixed-case\">GOC<\/jats:styled-content> discussion, with the first occurring a median of 53\u2009days post\u2010diagnosis. Targeted therapy\/immunotherapy was significantly associated with palliative care referrals (<jats:italic>p<\/jats:italic>\u2009=\u20090.004) and radiotherapy with <jats:styled-content style=\"fixed-case\">GOC<\/jats:styled-content> discussions (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Multivariate regression showed that targeted therapy\/immunotherapy was independently associated with palliative care referral (<jats:italic>p<\/jats:italic>\u2009=\u20090.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite national guidelines, many <jats:styled-content style=\"fixed-case\">ATC<\/jats:styled-content> patients do not receive timely palliative care referrals. The relationship between targeted therapies and higher rates of palliative care referrals and <jats:styled-content style=\"fixed-case\">GOC<\/jats:styled-content> discussions merits further study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.32243","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T09:23:07Z","timestamp":1746696187000},"page":"3444-3451","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multidisciplinary Care for Anaplastic Thyroid Cancer\u2014End\u2010of\u2010Life Care as a Standard of Care"],"prefix":"10.1002","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2723-9313","authenticated-orcid":false,"given":"Haidee","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery David Geffen School of Medicine  Los Angeles California 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