Mortality factors in recurrent parathyroid cancer: a pooled analysis

Tsai, Wen-Hsuan; Zeng, Yi-Hong; Lee, Chun-Chuan; Tsai, Ming-Chieh

doi:10.1007/s00774-021-01305-3

Cited by 5 publications

(3 citation statements)

References 81 publications

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“…Pathologic features such as the presence of vascular invasion, a Ki-67 proliferation index >5%, and negative parafibromin staining with a CDC73 mutation are associated with increased risk of recurrence and/or distant metastases 31,32. More recent studies have identified additional prognostic factors which include bone metastases, total number of surgeries <3 and disease-free interval ≤1 year 33–36. Primary treatment includes surgical excision with adequate resection margins with chemotherapy and radiotherapy showing limited benefit.…”

Section: Pathology Of Hyperparathyroidismmentioning

confidence: 99%

“…31,32 More recent studies have identified additional prognostic factors which include bone metastases, total number of surgeries <3 and disease-free interval ≤ 1 year. [33][34][35][36] Primary treatment includes surgical excision with adequate resection margins with chemotherapy and radiotherapy showing limited benefit. Five-and 10-year survival rates of 76% to 85% and 49% to 77%, respectively have been reported.…”

Section: Parathyroid Carcinomamentioning

confidence: 99%

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Advances and Updates in Parathyroid Pathology

Gokozan

Scognamiglio

2022

Advances in Anatomic Pathology

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Hyperparathyroidism is a common endocrine disorder characterized by elevated levels of parathyroid hormone and hypercalcemia and is divided into 3 types: primary, secondary, and tertiary. Distinction between these types is accomplished by correlation of clinical, radiologic, and laboratory findings with pathologic features. Primary hyperparathyroidism occurs sporadically in 85% of cases with the remaining cases associated with multiple familial syndromes. The pathologic manifestations of primary hyperparathyroidism include parathyroid adenoma, parathyroid hyperplasia, and parathyroid carcinoma. Recent advances in the understanding of the pathogenesis of parathyroid disease has helped to refine the diagnosis and classification of parathyroid lesions. The identification of multiple clonal proliferations in traditional multiglandular parathyroid hyperplasia has led to the adoption by the World Health Organization (WHO) of the alternate term of primary hyperparathyroidism-related multiglandular parathyroid disease. Additional nomenclature changes include the adoption of the term atypical parathyroid tumor in lieu of atypical parathyroid adenoma to reflect the uncertain malignant potential of these neoplasms. Clinical and morphologic features characteristic of familial disease have been described that can help the practicing pathologist identify underlying familial disease and provide appropriate management. Use of ancillary immunohistochemistry and molecular studies can be helpful in classifying parathyroid neoplasms. Parafibromin has proven useful as a diagnostic and prognostic marker in atypical parathyroid tumors and parathyroid carcinomas. This review provides an update on the diagnosis and classification of parathyroid lesions considering the recent advances in the understanding of the molecular and clinical features of parathyroid disease and highlights the use of ancillary studies (immunohistochemical, and molecular) to refine the diagnosis of parathyroid lesions.

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Section: Pathology Of Hyperparathyroidismmentioning

confidence: 99%

Section: Parathyroid Carcinomamentioning

confidence: 99%

Advances and Updates in Parathyroid Pathology

Gokozan

Scognamiglio

2022

Advances in Anatomic Pathology

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“…Patients who undergo parathyroidectomy have a remarkably better disease specific survival (DSS) and overall survival (OS) than patients who do not undergo definitive treatment [ 20 ] and more extensive oncological surgical approaches produce better results [ 20 ], in line with recommendations to aim for margin free outcomes in the first operation [ 21 , 22 ]. Failure at the initial stage is difficult to recuperate [ 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Mediastinal Parathyroid Cancer

Schulte

Galatà

Talat

2022

Cancers

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Parathyroid cancer (PC) is rare, but its pre-operative recognition is important to choose appropriate access strategies and achieve oncological clearance. This study characterizes features of mediastinal parathyroid cancer (MPC) and explores criteria aiding in the pre-operative recognition of malignancy. We assembled data from 502 patients with mediastinal parathyroid neoplasms (MPNs) from a systematic review of the literature 1968–2020 (n = 467) and our own patient cohort (n = 35). Thirty-two of the 502 MPNs (6.4%) exhibited malignancy. Only 23% of MPC patients underwent oncological surgery. Local persistence and early recurrence at a median delay of 24 months were frequent (45.8%), and associated with a 21.7-fold (95%CI 1.3–351.4; p = 0.03) higher risk of death due to disease. MPCs (n = 30) were significantly larger than cervical PC (n = 330), at 54 ± 36 mm vs. 35 ± 18 mm (χ2 = 20; p < 0.0001), and larger than mediastinal parathyroid adenomas (MPA; n = 226) at 22 ± 15 mm (χ2 = 33; p < 0.01). MPC occurred more commonly in males (60%; p < 0.01), with higher calcium (p < 0.01) and parathyroid hormone (PTH) levels (p < 0.01) than MPA. Mediastinal lesions larger than 3.0 cm and associated with a corrected calcium ≥ 3.0 mM are associated with a more than 100-fold higher odds ratio of being malignant (OR 109.2; 95%CI 1.1–346; p < 0.05). The composite 3 + 3 criterion recognized 74% of all MPC with an accuracy of 83%. Inversely, no MPN presenting with a calcium < 3.0 mM and size < 3.0 cm was malignant. When faced with pHPT in mediastinal location, consideration of the 3 + 3 rule may trigger an oncological team approach based on simple, available criteria.

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A Nomogram for Relapse/Death and Contemplating Adjuvant Therapy for Parathyroid Carcinoma

Silva¹

2023

Surgical Oncology Clinics of North America

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Mortality factors in recurrent parathyroid cancer: a pooled analysis

Cited by 5 publications

References 81 publications

Advances and Updates in Parathyroid Pathology

Advances and Updates in Parathyroid Pathology

Mediastinal Parathyroid Cancer

A Nomogram for Relapse/Death and Contemplating Adjuvant Therapy for Parathyroid Carcinoma

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