Trends in the incidence and treatment of parathyroid cancer in the United States

Abstract

BACKGROUND.Parathyroid cancer is a rare cause of hyperparathyroidism. The objectives of this study were to determine the patterns of disease, treatment trends, and outcomes among patients with parathyroid cancer by using a population‐based data source.METHODS.Surveillance, Epidemiology, and End Results (SEER) cancer registry data were used to identify patients who were diagnosed with parathyroid cancer from 1988 through 2003. To assess whether the incidence rate, treatment, tumor size, and cancer stage changed over time, the Cochrane‐Armitage trend test was used, and Cox proportional‐hazards modeling was used to identify the factors associated with an improved overall survival rate.RESULTS.From 1988 through 2003, 224 patients with parathyroid cancer were reported in the SEER data. Over that 16‐year study period, the incidence of parathyroid cancer increased by 60% (1988–1991, 3.58 per 10,000,000 population; 2000–2003, 5.73 per 10,000,000 population). Most patients (96%) underwent surgery (parathyroidectomy, 78.6% of patients; en bloc resection, 12.5% of patients; other, 4.9% of patients). The rate of surgical treatment increased significantly during the study period. The 10‐year all‐cause mortality rate was 33.2%, and the 10‐year cancer‐related mortality rate was 12.4%. Patient age (P < .0001), sex (P = .0106), the presence of distant metastases at diagnosis (P = .0004), and the year of diagnosis (P = .0287) were associated significantly with the overall survival rate. Tumor size, lymph node status, and type of surgery were not associated significantly with the overall survival rate.CONCLUSIONS.Although parathyroid cancer is rare, the incidence increased significantly in the United States from 1988 through 2003. Young age, female gender, recent year of diagnosis, and absence of distant metastases were associated significantly with an improved survival rate. Cancer 2007. © 2007 American Cancer Society.

Differential expression of microRNAs in human parathyroid carcinomas compared with normal parathyroid tissue

“…Indeed, there are several limitations that prevented molecular genetic analysis of these carcinomas in large scale. First, PaCs are a rare disease with an estimated incidence of 5.7 per 10 000 000 population (Lee et al 2007). Secondly, patients with PaCs are severely hypercalcemic, and the unaffected parathyroids, if available, cannot be used as control since it is known that calcium modulates gene expression (Brown & MacLeod 2001).…”

Evaluation of preoperative ultrasonographic and biochemical features of patients with aggressive parathyroid disease: is there a reliable predictive marker?

“…Cancer is rarely seen and represents 0.005% of all cancers and < 1% of cases of PHPT in the United States. It affects men and women equally, and its management and outcome are variable (1,2).…”

Mediastinal Parathyroid Adenoma Mimicking Cancer Metastatic to Bone

“…The incidence of parathyroid cancer is rare; it accounts for between 0.5 and 5% of all cases of primary hyperparathyroidism (16). It poses a diagnostic challenge due to the lack of features that can definitively distinguish malignant from benign disease early in the clinical course (17).…”

“…Our patient's high PTH level contributed to the consideration that he might have parathyroid carcinoma. However, only 4.5% of patients with parathyroid cancer present with distant metastasis (16), likely because most patients present earlier from symptoms of hypercalcemia, bone pain, and renal stones.…”