Time to Recurrence as a Prognostic Factor in Parathyroid Carcinoma.

Autor:	Magnabosco FF; Division of Head and Neck Surgery, LIM-28, Laboratorio de Cirurgia de Cabeca e Pescoco, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, 05403-000, Brazil., Brescia MDG; Division of Head and Neck Surgery, LIM-28, Laboratorio de Cirurgia de Cabeca e Pescoco, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, 05403-000, Brazil., Nascimento Júnior CP; Division of Head and Neck Surgery, LIM-28, Laboratorio de Cirurgia de Cabeca e Pescoco, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, 05403-000, Brazil., Massoni Neto LM; Division of Head and Neck Surgery, LIM-28, Laboratorio de Cirurgia de Cabeca e Pescoco, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, 05403-000, Brazil., Arap SS; Division of Head and Neck Surgery, LIM-28, Laboratorio de Cirurgia de Cabeca e Pescoco, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, 05403-000, Brazil., de Castro Junior G; Department of Clinical Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, SP, 05403-000, Brazil., Ledesma FL; Department of Pathology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, SP, 05403-000, Brazil., Ferreira Alves VA; Department of Pathology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, SP, 05403-000, Brazil., Kowalski LP; Division of Head and Neck Surgery, LIM-28, Laboratorio de Cirurgia de Cabeca e Pescoco, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, 05403-000, Brazil., Martin RM; Division of Endocrinology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, SP, 05403-000, Brazil., de Menezes Montenegro FL; Division of Head and Neck Surgery, LIM-28, Laboratorio de Cirurgia de Cabeca e Pescoco, Hospital das Clínicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, 05403-000, Brazil.
Jazyk:	angličtina
Zdroj:	Journal of the Endocrine Society [J Endocr Soc] 2023 May 23; Vol. 7 (7), pp. bvad067. Date of Electronic Publication: 2023 May 23 (Print Publication: 2023).
DOI:	10.1210/jendso/bvad067
Abstrakt:	Background: 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 2 had distant metastases. Parathyroidectomy with ipsilateral thyroidectomy was performed in 82.2%. Mean postoperative calcium levels were different between patients who developed recurrence vs those who did not ( P = .03). Six patients (40%) had no recurrence during follow-up, 2 (13.3%) only regional, 3 (20%) only distant, and 4 (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 Tumor, Nodule, Metastasis system nor largest tumor dimension ( P = .29 and P = .74, respectively) were predictive of death. En bloc resection was not superior to other surgical modalities ( P = .97). Time between initial treatment and development of recurrence negatively impacted overall survival rate at 36 months ( P = .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 patients with disease recurrence within 36 months of initial surgery had a lower survival rate. (© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society.)
Databáze:	MEDLINE
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