Faculty Collaboration Database

Parathyroid Carcinoma: An Update on Treatment Outcomes and Prognostic Factors from the National Cancer Data Base (NCDB). Ann Surg Oncol 2015 Nov;22(12):3990-5

Date

06/17/2015

Pubmed ID

26077914

DOI

10.1245/s10434-015-4672-3

Scopus ID

2-s2.0-84943350542 (requires institutional sign-in at Scopus site)   114 Citations

Abstract

BACKGROUND: Parathyroid carcinoma is a rare disease. Conflicting results on prognostic factors and extent of surgical resection for patients with parathyroid carcinoma have been made based on small sample sizes. A large, robust dataset is needed to help address some of the controversies.

METHODS: A retrospective review of patients with parathyroid carcinoma in the National Cancer Data Base from 1985 to 2006 was performed. Characteristics of the cohort and type of treatment were evaluated. Prognostic factors were assessed with Cox proportional hazards regression models and 5- and 10-year OS rates were determined.

RESULTS: There were 733 evaluable patients with a mean age of 56.1 ± 15.3 years (median 57, range 15-89) and mean tumor size of 29.6 ± 18.4 mm (median 25.0 mm, range 10.0-150.0). Tumor size, age at diagnosis, male sex, positive nodal status, and complete tumor resection had hazard ratios for death of 1.02 (1.01-1.02, p < 0.0001), 1.06 (1.05-1.07, p < 0.0001), 1.67 (1.24-2.25, p = 0.0008), 1.25 (0.57-2.76, p = 0.6), and 0.42 (0.22-0.81, p = 0.01), respectively, on multivariable analysis. Patients who had removal of the parathyroid tumor with concomitant resection of adjacent organs had HR for death of 0.70 (0.35-1.41, p = 0.3). The 5- and 10-year OS rates were 82.3 and 66 % respectively.

CONCLUSIONS: Patient age, tumor size, and sex have modest effects on survival in patients with parathyroid carcinoma. A staging system with prognostic value for parathyroid carcinoma should include at least these pertinent prognostic factors.

Author List

Asare EA, Sturgeon C, Winchester DJ, Liu L, Palis B, Perrier ND, Evans DB, Winchester DP, Wang TS

Authors

Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of Wisconsin
Tracy S. Wang MD, MPH Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Carcinoma
Databases, Factual
Female
Humans
Lymphatic Metastasis
Male
Middle Aged
Neoplasm, Residual
Parathyroid Neoplasms
Prognosis
Proportional Hazards Models
Retrospective Studies
Sex Factors
Survival Rate
Tumor Burden
United States
Young Adult