Parathyroid surgery during the COVID-19 pandemic: Time to think about the “New Normal”

Backgroud Parathyroid carcinoma (PC) is a rare and challenging disease without clearly understood prognostic factors. Adequate management can improve outcomes. Characteristics of patients treated for PC over time and factors affecting prognosis were analyzed. Methods Retrospective cohort study including surgically treated patients for PC between 2000 and 2021. If malignancy was suspected, free-margin resection was performed. Demographic, clinical, laboratory, surgical, pathological, and follow-up characteristics were assessed. Results Seventeen patients were included. Mean tumor size was 32.5 mm, with 64.7% staged as pT1/pT2. None had lymph node involvement at admission, and two had distant metastases. Parathyroidectomy with ipsilateral thyroidectomy was performed in 82.2%. Mean postoperative Calcium levels were different between patients who developed recurrence versus those who did not (p=0.03). Six patients (40%) had no recurrence during follow-up, two (13.3%) only regional, three (20%) only distant, and four (26.6%) both regional and distant. At 5 and 10 years, 79% and 56% of patients were alive, respectively. Median disease-free survival was 70 months. Neither TNM system nor largest tumor dimension (p=0.29 and p=0.74, respectively) were predictive of death. En bloc resection was not superior to other surgical modality (p=0.97). Time between initial treatment and development of recurrence negatively impacted overall survival rate at 36 months (p=0.01). Conclusion Patients with PC can survive for decades and have indolent disease course. Free margins seem to be the most important factor in initial surgery. Recurrence was common (60%), but those with disease recurrence within 36 months of initial surgery had a lower survival rate.

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Parathyroid surgery during the COVID-19 pandemic: Time to think about the “New Normal”

Cited by 2 publications

References 28 publications

Potential impacts of SARS-CoV-2 on parathyroid: current advances and trends

Potential impacts of SARS-CoV-2 on parathyroid: current advances and trends

Time to Recurrence as a Prognostic Factor in Parathyroid Carcinoma

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