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Anaplastic thyroid cancer (ATC) responds poorly to conventional therapies and requires a multidisciplinary approach to manage. The aim of the current study is to explore whether aggressive treatment is beneficial, especially the appropriate extent of surgery in ATC. Methods<\/jats:italic>. Patients diagnosed with ATC from 2004 to 2014 were identified from the Surveillance, Epidemiology, and End Results (SEER) database and included in our study. Results<\/jats:italic>. A total of 735 ATC patients were identified. The two-year overall survival (OS) rates for stage IVA, IVB, and IVC patients were 36.5%, 15.6%, and 1.4%, respectively. By directly comparing eight treatment modalities, we found that surgery<\/mml:mtext>+<\/mml:mo>radiotherapy<\/mml:mtext>\u2009<\/mml:mtext>RT<\/mml:mtext><\/mml:mrow><\/mml:mfenced>\u00b1<\/mml:mo>chemotherapy<\/mml:mtext><\/mml:math> was the most effective treatment strategy. surgery<\/mml:mtext>+<\/mml:mo>chemotherapy<\/mml:mtext><\/mml:math> and RT<\/mml:mtext>+<\/mml:mo>chemotherapy<\/mml:mtext><\/mml:math> had comparable results (hazard ratio HR<\/mml:mtext><\/mml:mrow><\/mml:mfenced>=<\/mml:mo>1.461<\/mml:mn><\/mml:math>, 95% confidential interval (CI): 0.843-2.531, P<\/mml:mi>=<\/mml:mo>0.177<\/mml:mn><\/mml:math>). Multivariate Cox regression analysis also showed increased mortality risk in patients with increased age (HR<\/mml:mtext>=<\/mml:mo>1.022<\/mml:mn><\/mml:math>, P<\/mml:mi><<\/mml:mo>0.001<\/mml:mn><\/mml:math>), tumor extension to adjacent structures (HR<\/mml:mtext>=<\/mml:mo>1.649<\/mml:mn><\/mml:math>, P<\/mml:mi>=<\/mml:mo>0.013<\/mml:mn><\/mml:math>), and distant metastasis (HR<\/mml:mtext>=<\/mml:mo>2.041<\/mml:mn><\/mml:math>, P<\/mml:mi><<\/mml:mo>0.001<\/mml:mn><\/mml:math>), while surgery<\/mml:mtext>+<\/mml:mo>RT<\/mml:mtext><\/mml:math> (HR<\/mml:mtext>=<\/mml:mo>0.600<\/mml:mn><\/mml:math>, P<\/mml:mi>=<\/mml:mo>0.004<\/mml:mn><\/mml:math>) and chemotherapy (HR<\/mml:mtext>=<\/mml:mo>0.692<\/mml:mn><\/mml:math>, P<\/mml:mi>=<\/mml:mo>0.010<\/mml:mn><\/mml:math>) were independently associated with improved OS. Further analysis revealed that patients undergoing total\/near-total thyroidectomy (TT) had superior OS to those receiving less than TT (P<\/mml:mi><<\/mml:mo>0.001<\/mml:mn><\/mml:math>). In subgroup analysis, the benefit of TT remained significant in patients with tumors larger than 4.0\u2009cm (HR<\/mml:mtext>=<\/mml:mo>0.776<\/mml:mn><\/mml:math>, 95% CI: 0.469-0.887, P<\/mml:mi>=<\/mml:mo>0.007<\/mml:mn><\/mml:math>), with adjacent structure extension (HR<\/mml:mtext>=<\/mml:mo>0.642<\/mml:mn><\/mml:math>, 95% CI: 0.472-0.877, P<\/mml:mi>=<\/mml:mo>0.005<\/mml:mn><\/mml:math>), including trachea and major vessels, but not in patients with early phase local disease such as tumor<\/mml:mtext>\u2264<\/mml:mo>4.0<\/mml:mn>\u2009<\/mml:mtext>cm<\/mml:mtext><\/mml:math> or tumor within the thyroid or with minimal extrathyroidal extension. Patients with very locally advanced disease or distant metastasis could not benefit from TT as well. Conclusions<\/jats:italic>. In operable cases, surgery<\/mml:mtext>+<\/mml:mo>RT<\/mml:mtext>\u00b1<\/mml:mo>chemotherapy<\/mml:mtext><\/mml:math> was the optimal treatment modality. Otherwise, RT<\/mml:mtext>+<\/mml:mo>chemotherapy<\/mml:mtext><\/mml:math> was the appropriate strategy. However, TT was not beneficial for very early stage or metastatic ATC.<\/jats:p>","DOI":"10.1155\/2019\/8428547","type":"journal-article","created":{"date-parts":[[2019,2,19]],"date-time":"2019-02-19T23:31:49Z","timestamp":1550619109000},"page":"1-7","source":"Crossref","is-referenced-by-count":22,"title":["An Update of the Appropriate Treatment Strategies in Anaplastic Thyroid Cancer: A Population-Based Study of 735 Patients"],"prefix":"10.1155","volume":"2019","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7623-5744","authenticated-orcid":true,"given":"Nai-si","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China"},{"name":"Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, 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