Local resection versus radical surgery for parathyroid carcinoma: A National Cancer Database analysis

Leonard-Murali, Shravan; Ivanics, Tommy; Kwon, David S.; Han, Xiaodong; Steffes, Christopher P.; Shah, Rupen

doi:10.1016/j.ejso.2021.06.026

Cited by 14 publications

(9 citation statements)

References 19 publications

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“…Surgery is rarely curative in cases with distant metastases, although palliative debulking of the tumor mass may aid in controlling hypercalcemia [11] . In the largest cohort evaluating the overall survival of PC patients, no significant difference was found between en bloc resection and local resection [14] . Radical en bloc resection is controversial, because it leads to significant morbidities, such as muscular dysfunction and laryngeal nerve palsies [14] , [15] .…”

Section: Discussionmentioning

confidence: 87%

“…In the largest cohort evaluating the overall survival of PC patients, no significant difference was found between en bloc resection and local resection [14] . Radical en bloc resection is controversial, because it leads to significant morbidities, such as muscular dysfunction and laryngeal nerve palsies [14] , [15] . Locoregional surgeries, including ipsilateral parathyroidectomy, were found useful in certain situations, such as local disease control, when a less aggressive approach was opted for.…”

Section: Discussionmentioning

confidence: 87%

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Case series of diagnosis and surgery challenges in parathyroid carcinoma

Kartini

Kurnia

Yulian

et al. 2022

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 87%

Case series of diagnosis and surgery challenges in parathyroid carcinoma

Kartini

Kurnia

Yulian

et al. 2022

International Journal of Surgery Case Reports

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“…The significance of ipsilateral cervical lymph node dissection (LND) during the initial surgery for PC has not been established. Most previous single-center studies indicate that radical resection helps to decrease the risk of recurrence, while the results obtained by analyzing large-scale cancer register databases, such as the SEER (Surveillance, Epidemiology, and End Result) database and the NCBD (National Cancer Database), did not confirm this finding [ 12 , 13 , 14 , 15 ]. This uncertainty regarding the extent of resection required interferes with PC management.…”

Section: Introductionmentioning

confidence: 93%

“…Surgery remains the mainstay of PC treatment as chemotherapy and radiotherapy are ineffective. Even though radical resection with en bloc resection of the parathyroid tumor and ipsilateral thyroid robe is suggested for PC in most published literature, the optimal excision extent is still in dispute [ 6 , 12 , 13 , 14 ]. The significance of ipsilateral cervical lymph node dissection (LND) during the initial surgery for PC has not been established.…”

Section: Introductionmentioning

confidence: 99%

Patterns and Predictors of Cervical Lymph Node Metastasis in Parathyroid Carcinoma

Cui

Chang

et al. 2022

Cancers

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Background: Parathyroid carcinoma (PC) is a rare endocrine malignancy with poor outcomes. Over 60% of PC patients experience repeated disease recurrence or metastasis. The significance of cervical lymph node dissection (LND) for PC remains inconclusive. Methods: PC patients diagnosed at Peking Union Medical College Hospital between 1992 and 2021 were reviewed retrospectively. Clinical data, initial tumor histological staging, parafibromin histochemical staining results, Ki67 index, CDC73 gene mutation status and outcome information were collected systemically. The risk factors for recurrence and lymph node or distant metastasis were explored. Results: Sixty-eight PC patients receiving LND were enrolled. Cervical lymph node metastasis was identified in 19.4% of patients at initial surgery and 25.0% of patients including reoperations for recurrences. The independent risk factor for PC recurrence was a Ki67 index ≥ 5% (HR4.41, 95% confidence interval (CI)1.30–14.95, p = 0.017). Distant metastasis was an independent prognostic factor for PC patient overall survival (HR 5.44, 95% CI 1.66–17.82, p = 0.005). High-risk Schulte staging (p = 0.021) and CDC73 abnormalities (p = 0.012) were risk factors for cervical lymph node metastasis. Conclusion: Most PCs were slow-growing, but lymph node metastasis was not rare. For patients planning to undergo remedial surgery after previous local resection of PC, central LND is suggested for tumors with high-risk Schulte staging or CDC73 abnormalities.

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“…This results in a poor survival rate, with 85% of the patients dying within 5 years ( 3 ). Moreover, the presence of a metastatic lesion at diagnosis and the tumor size are worse prognostic factor ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

The Long Non-Coding BC200 Is a Novel Circulating Biomarker of Parathyroid Carcinoma

et al. 2022

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Long non-coding RNAs (lncRNAs) are an important class of epigenetic regulators involved in both physiological processes and cancer development. Preliminary evidence suggested that lncRNAs could act as accurate prognostic and diagnostic biomarkers. Parathyroid cancer is a rare endocrine neoplasia, whose management represents a clinical challenge due to the lack of accurate molecular biomarkers. Our previous findings showed that human parathyroid tumors are characterized by a different lncRNAs signature, suggesting heterogeneity through the different histotypes. Particularly, we found that the lncRNA BC200/BCYRN1 could represent a candidate biomarker for parathyroid carcinomas (PCas). Here we aimed to extend our preliminary data evaluating whether BC200 could be an accurate non-invasive biomarker of PCas to support the clinical management of patients affected by parathyroid tumors at diagnosis, prognosis and follow-up. To provide a non-invasive point-of-care for parathyroid carcinoma diagnosis and follow-up, we analyzed BC200 expression in patients’ serum through digital PCR. Our results show that BC200 counts are higher in serum from patients harboring PCa (n=4) compared to patients with parathyroid adenoma (PAd; n=27). Further, in PAd patients circulating BC200 levels are positively correlated with serum total calcium. Then, we found that BC200 is overexpressed in metastatic PCas (n=4) compared to non-metastatic ones (n=9). Finally, the lncRNA expression in PCa patients’ serum drops are reduced after parathyroidectomy, suggesting its possible use in the post-operative setting for patients follow-up. Overall, these findings extend the knowledge on BC200 in parathyroid tumors, supporting its role as a useful biomarker for management of PCa.

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Local resection versus radical surgery for parathyroid carcinoma: A National Cancer Database analysis

Cited by 14 publications

References 19 publications

Case series of diagnosis and surgery challenges in parathyroid carcinoma

Case series of diagnosis and surgery challenges in parathyroid carcinoma

Patterns and Predictors of Cervical Lymph Node Metastasis in Parathyroid Carcinoma

The Long Non-Coding BC200 Is a Novel Circulating Biomarker of Parathyroid Carcinoma

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