Is central lymph node dissection necessary for parathyroid carcinoma? Surgery 2014 Dec;156(6):1336-41; discussion 1341
Date
12/03/2014Pubmed ID
25456903Pubmed Central ID
PMC4254726DOI
10.1016/j.surg.2014.08.005Scopus ID
2-s2.0-84922417644 (requires institutional sign-in at Scopus site) 65 CitationsAbstract
BACKGROUND: Parathyroid carcinoma is a rare cancer. Unlike other more common malignancies, the importance of lymph node (LN) status remains controversial. The purpose of this study was to determine the relative importance of LN metastases in disease-specific survival (DSS).
METHODS: A retrospective review of the Surveillance, Epidemiology, and End Result database was performed on parathyroid carcinoma cases diagnosed between 1988 and 2010.
RESULTS: We identified 405 parathyroid carcinoma patients. Among 114 patients with LNs examined at operation, only 12 (10.5%) had positive LNs. Sensitivity analysis found that a tumor size threshold of 3 cm best divided the cohort by DSS. Only tumors ≥ 3 cm and distant metastasis but not LN metastases were independent prognostic factors on multivariate analysis. When examining factors associated with LN status, only tumors ≥ 3 cm predicted LN metastasis. LN metastases were 7.5 times more likely in patients with tumors ≥ 3 cm than those with tumors <3 cm.
CONCLUSION: Tumors ≥ 3 cm were associated with LN metastases in parathyroid carcinoma, but positive LN status was not associated with DSS. Tumor size can potentially risk stratify patients by their risk of LN metastases.
Author List
Hsu KT, Sippel RS, Chen H, Schneider DFAuthor
Kun-Tai Hsu MD Assistant Professor in the Plastic Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdenomaAged
Cohort Studies
Confidence Intervals
Disease-Free Survival
Female
Humans
Lymph Node Excision
Lymph Nodes
Male
Middle Aged
Multivariate Analysis
Neoplasm Invasiveness
Neoplasm Staging
Odds Ratio
Parathyroid Neoplasms
Parathyroidectomy
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Rare Diseases
Retrospective Studies
Risk Assessment
SEER Program
Survival Analysis
Treatment Outcome
