Oncologic progress for the treatment of parathyroid carcinoma is needed

Abstract

Management of PC and patient outcomes (OS and DFS) have not significantly changed over the past 35 years at our institution. This rare malignancy needs oncologic improvement. J. Surg. Oncol. 2016;114:708-713. © 2016 Wiley Periodicals, Inc.

Hypercalcemia and cancer: Differential diagnosis and treatment

“…PC is rare (less than 1% of all cases of PHPT) and often is not diagnosed until after surgery . Once the diagnosis of PC is established, these patients should be referred to a tertiary facility with multidisciplinary teams specialized in the treatment of PC . Surgical treatment goals are to resect all tumor with negative margins without fracture of the specimen and without causing spillage of tumor cells onto the surgical field; resection of adjacent, uninvolved compartments is not necessary.…”

“…25 Once the diagnosis of PC is established, these patients should be referred to a tertiary facility with multidisciplinary teams specialized in the treatment of PC. 24,26,27 Surgical treatment goals are to resect all tumor with negative margins without fracture of the specimen and without causing spillage of tumor cells onto the surgical field; resection of adjacent, uninvolved compartments is not necessary. When the disease is not resectable, the calcimimetic cinacalcet can be used to partially suppress PTH secretion by the tumor.…”

Non-functioning parathyroid cystic tumour: malignant or not? Report of a case

“…An "en bloc" resection of the primary mass and surrounding tissues involved (adherent or infiltrated) is the widely accepted surgical option. The prognosis depends on the complete resection of the tumour: if the margins of resection are free of neoplastic tissue it is probable to obtain a good prognosis (5)(6)(7)(19)(20).…”

“…Long-term follow-up and information on mortality are not available, but the advanced stage of the PC at diagnosis likely predict a poor prognosis, worse than that of patients with classical hypercalcemic PC (2,7,9,(49)(50)(51)(52)(53). In the present case, we preferred to perform a thyroid lobectomy because of the pre-existent ipsi-lateral vocal fold paralysis and for taking the opportunity of avoiding the possible sequelae and complications of the total thyroidectomy (57)(58)(59)).…”

Current and Future Treatments for Parathyroid Carcinoma

“…In the past, small cohorts of patients have undergone external beam radiation therapy for treatment of disease considered unresectable, however utility of this is questioned as a fair number of PC tumors are considered radioresistant [35][36][37]. No benefit for overall survival or local recurrence has been clearly identified, and use of radiotherapy is often restricted to palliative treatment of advanced disease or in the presence of distant disease [4,7,[36][37]. Cytotoxic chemotherapy is used even less frequently than external beam radiation therapy, and only isolated reports with very small numbers of patients exist [37,38].…”