Tumor Size and Presence of Metastatic Disease at Diagnosis are Associated with Disease-Specific Survival in Parathyroid Carcinoma

Abstract

The incidence of parathyroid carcinoma has remained stable over the past decade. Tumor size < 3 cm and regional disease have increased in incidence. Patients with metastatic disease and tumors > 3 cm have worse cancer-specific survival. These findings can be incorporated in the development of a staging system for parathyroid carcinoma.

The Use and Benefit of Adjuvant Radiotherapy in Parathyroid Carcinoma: A National Cancer Database Analysis

“…Variables were included in the multivariable Cox regression regardless of result in the univariable analysis in order to adequately assess factors previously reported in the literature to impact OS. 1,9,12,13,25 In addition, to help account for the nonrandom treatment assignment of EBRT, inverse probability weighting (IPW) using propensity scores was performed to reduce the effects of confounders. Individual propensities of undergoing EBRT were estimated using a multivariable logistic regression model including the covariates age, comorbidity score, treatment facility county and type, tumor size and extension, nodal and distant metastasis, type of procedure, and success of surgical resection.…”

“…Parathyroid carcinoma (PC) is a rare malignancy, accounting for approximately 11 cases per 10 million people in the United States, and less than 1% of all patients with primary hyperparathyroidism [1][2][3][4][5][6] Preoperative diagnosis is difficult, and the majority of patients are diagnosed at the time of surgery or postoperatively on final pathology. Patients with PC typically suffer from multiple recurrences, undergo numerous surgical resections, and eventually develop metastases.…”

Severe symptomatic hyperparathyroidism—Is it carcinoma?—Case report and literature review

“…Parathyroid carcinoma is a rare endocrine neoplasia, with an incidence of approximately 11 cases per 10 million persons per year, 11,12 corresponding to less than 1% of all cases of primary hyperparathyroidism. 6,13 The pathogenesis of parathyroid carcinoma is still not well known, but is probably related with the interaction of several genetic and environmental factors.…”

“…In these cases, diagnosis is often made at more advanced stages, due to mass effect symptoms or local invasion. 12,18 The finding of dysphonia, due to laryngeal recurrent nerve invasion and palsy, strongly suggests malignancy, mainly if there is no past history of neck surgery. 6,23 Personal or familiar history of hyperparathyroidism or genetic syndromes associated with parathyroid carcinoma, like HPT-JT and MEN1, should also raise clinical suspicion.…”

HEREDITARY ENDOCRINE TUMOURS: CURRENT STATE-OF-THE-ART AND RESEARCH OPPORTUNITIES: New and future perspectives for parathyroid carcinoma

“…Challenging aspects in the management of this malignancy include the only recent availability of preclinical models; the late diagnosis due to the lack of specific symptoms and signs (but very severe symptomatic hypercalcemia and a younger age at diagnosis), lack of specific histopathologic definition of PC and of radiological exams to be performed in follow-up, with consequent high recurrence and low survival rates in metastatic disease (Wei & Harari 2012, Lo et al 2018; the limited experience in the surgical approach to PC due to the rarity of the disease; the absence of efficacious targeted pharmacological therapeutics in PC. Only with combined efforts to coalesce data will there be an ability to make an impact on the morbidity and mortality of this disease.…”