Clinical Presentation, Staging and Long-Term Evolution of Parathyroid Cancer
Background Parathyroid cancer is rare and often fatal. This review provides an in-depth analysis of 330 clinical cases reported in detail. These data are used to inform a proposal for a hitherto lacking TNM staging system. Materials and Methods All case reports or series with sufficient case details...
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| Veröffentlicht in: | Annals of surgical oncology 2010-08, Vol.17 (8), p.2156-2174 |
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| creator | Talat, Nadia Schulte, Klaus-Martin |
| description | Background
Parathyroid cancer is rare and often fatal. This review provides an in-depth analysis of 330 clinical cases reported in detail. These data are used to inform a proposal for a hitherto lacking TNM staging system.
Materials and Methods
All case reports or series with sufficient case details of parathyroid cancer were identified from PubMed, and data were analyzed using SPSS.
Results
Of 330 patients, 117 (35%) died of disease and 207 (63%) experienced recurrence in a total of 2007 follow-up years and a mean length of follow-up of 6.1 years. Histopathology findings rather than biochemical or clinical features predict outcome. In univariate analysis, survival and recurrence rates are significantly influenced by gender (male relative risk [RR] 1.7, 95% confidence interval [95% CI] 1.0–2.7,
P
|
| doi_str_mv | 10.1245/s10434-010-1003-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_733647662</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>733647662</sourcerecordid><originalsourceid>FETCH-LOGICAL-c370t-8e6a714bb76258e6c3a73af8169af1b337261d0f190ff5654629619fd29ae423</originalsourceid><addsrcrecordid>eNp1kEtLw0AQxxdRfFQ_gBcJXrwYndlnc5RQH1CwYO_LNtmtkXRXdxOh397U-gDB07x-85_hT8gpwhVSLq4TAmc8B4QcAVgud8ghiqHD5Rh3hxzkOC-oFAfkKKUXAFQMxD45oEApKuCHZFq2jW8q02azaJP1nema4C-zp84sG7_MjK-zafDLfG7jKpu8h7bfAFlw2cxE0z2vY2jqrDS-svGY7DnTJnvyFUdkfjuZl_f59PHuobyZ5hVT0OVjK41CvlgoScVQVMwoZtwYZWEcLhhTVGINDgtwTkjBJS0kFq6mhbGcshG52Mq-xvDW29TpVZMq27bG29AnrRiTXEm5Ic__kC-hj374TUsoGBfiE8ItVMWQUrROv8ZmZeJaI-iNz3rrs4ZNPfis5bBz9iXcL1a2_tn4NnYA6BZIw8gvbfy9_L_qBxt1hgU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>609345562</pqid></control><display><type>article</type><title>Clinical Presentation, Staging and Long-Term Evolution of Parathyroid Cancer</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Talat, Nadia ; Schulte, Klaus-Martin</creator><creatorcontrib>Talat, Nadia ; Schulte, Klaus-Martin</creatorcontrib><description>Background
Parathyroid cancer is rare and often fatal. This review provides an in-depth analysis of 330 clinical cases reported in detail. These data are used to inform a proposal for a hitherto lacking TNM staging system.
Materials and Methods
All case reports or series with sufficient case details of parathyroid cancer were identified from PubMed, and data were analyzed using SPSS.
Results
Of 330 patients, 117 (35%) died of disease and 207 (63%) experienced recurrence in a total of 2007 follow-up years and a mean length of follow-up of 6.1 years. Histopathology findings rather than biochemical or clinical features predict outcome. In univariate analysis, survival and recurrence rates are significantly influenced by gender (male relative risk [RR] 1.7, 95% confidence interval [95% CI] 1.0–2.7,
P
< .01), and presence of vascular invasion (RR 4.3, 95% CI 1.1–17.7,
P
< .01), or lymph node metastases (RR 6.2, 95 %CI 0.9–42.9,
P
< .001). Failure to perform oncological surgery carries a high risk for recurrence and death (local versus
en bloc
resection RR 2.0, CI 1.2–3.2,
P
< .01) as for redo surgery. Staging by a novel anatomy-based TNM system identifies significant outcome variation as to recurrence and death. Separation of patients into low and high risk identifies a 3.5–7.0 fold higher risk of recurrence and death (
P
< .01) for the high-risk group. Distant metastases predominantly target mediastinum and lung.
Conclusion
Understaging and undertreatment are shown to contribute to high recurrence rates and death toll. To improve outcome,
en bloc
resection including central lymph node dissection should be the minimal surgical approach in any patient with suspected parathyroid cancer.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-010-1003-6</identifier><identifier>PMID: 20221704</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Endocrine Tumors ; Female ; Follow-Up Studies ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging - methods ; Oncology ; Parathyroid Neoplasms - mortality ; Parathyroid Neoplasms - pathology ; Risk Factors ; Surgery ; Surgical Oncology ; Survival Rate</subject><ispartof>Annals of surgical oncology, 2010-08, Vol.17 (8), p.2156-2174</ispartof><rights>Society of Surgical Oncology 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c370t-8e6a714bb76258e6c3a73af8169af1b337261d0f190ff5654629619fd29ae423</citedby><cites>FETCH-LOGICAL-c370t-8e6a714bb76258e6c3a73af8169af1b337261d0f190ff5654629619fd29ae423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-010-1003-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-010-1003-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,778,782,27911,27912,41475,42544,51306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20221704$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Talat, Nadia</creatorcontrib><creatorcontrib>Schulte, Klaus-Martin</creatorcontrib><title>Clinical Presentation, Staging and Long-Term Evolution of Parathyroid Cancer</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Parathyroid cancer is rare and often fatal. This review provides an in-depth analysis of 330 clinical cases reported in detail. These data are used to inform a proposal for a hitherto lacking TNM staging system.
Materials and Methods
All case reports or series with sufficient case details of parathyroid cancer were identified from PubMed, and data were analyzed using SPSS.
Results
Of 330 patients, 117 (35%) died of disease and 207 (63%) experienced recurrence in a total of 2007 follow-up years and a mean length of follow-up of 6.1 years. Histopathology findings rather than biochemical or clinical features predict outcome. In univariate analysis, survival and recurrence rates are significantly influenced by gender (male relative risk [RR] 1.7, 95% confidence interval [95% CI] 1.0–2.7,
P
< .01), and presence of vascular invasion (RR 4.3, 95% CI 1.1–17.7,
P
< .01), or lymph node metastases (RR 6.2, 95 %CI 0.9–42.9,
P
< .001). Failure to perform oncological surgery carries a high risk for recurrence and death (local versus
en bloc
resection RR 2.0, CI 1.2–3.2,
P
< .01) as for redo surgery. Staging by a novel anatomy-based TNM system identifies significant outcome variation as to recurrence and death. Separation of patients into low and high risk identifies a 3.5–7.0 fold higher risk of recurrence and death (
P
< .01) for the high-risk group. Distant metastases predominantly target mediastinum and lung.
Conclusion
Understaging and undertreatment are shown to contribute to high recurrence rates and death toll. To improve outcome,
en bloc
resection including central lymph node dissection should be the minimal surgical approach in any patient with suspected parathyroid cancer.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Endocrine Tumors</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local</subject><subject>Neoplasm Staging - methods</subject><subject>Oncology</subject><subject>Parathyroid Neoplasms - mortality</subject><subject>Parathyroid Neoplasms - pathology</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival Rate</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kEtLw0AQxxdRfFQ_gBcJXrwYndlnc5RQH1CwYO_LNtmtkXRXdxOh397U-gDB07x-85_hT8gpwhVSLq4TAmc8B4QcAVgud8ghiqHD5Rh3hxzkOC-oFAfkKKUXAFQMxD45oEApKuCHZFq2jW8q02azaJP1nema4C-zp84sG7_MjK-zafDLfG7jKpu8h7bfAFlw2cxE0z2vY2jqrDS-svGY7DnTJnvyFUdkfjuZl_f59PHuobyZ5hVT0OVjK41CvlgoScVQVMwoZtwYZWEcLhhTVGINDgtwTkjBJS0kFq6mhbGcshG52Mq-xvDW29TpVZMq27bG29AnrRiTXEm5Ic__kC-hj374TUsoGBfiE8ItVMWQUrROv8ZmZeJaI-iNz3rrs4ZNPfis5bBz9iXcL1a2_tn4NnYA6BZIw8gvbfy9_L_qBxt1hgU</recordid><startdate>20100801</startdate><enddate>20100801</enddate><creator>Talat, Nadia</creator><creator>Schulte, Klaus-Martin</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20100801</creationdate><title>Clinical Presentation, Staging and Long-Term Evolution of Parathyroid Cancer</title><author>Talat, Nadia ; Schulte, Klaus-Martin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c370t-8e6a714bb76258e6c3a73af8169af1b337261d0f190ff5654629619fd29ae423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Endocrine Tumors</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local</topic><topic>Neoplasm Staging - methods</topic><topic>Oncology</topic><topic>Parathyroid Neoplasms - mortality</topic><topic>Parathyroid Neoplasms - pathology</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Talat, Nadia</creatorcontrib><creatorcontrib>Schulte, Klaus-Martin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Talat, Nadia</au><au>Schulte, Klaus-Martin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Presentation, Staging and Long-Term Evolution of Parathyroid Cancer</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2010-08-01</date><risdate>2010</risdate><volume>17</volume><issue>8</issue><spage>2156</spage><epage>2174</epage><pages>2156-2174</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
Parathyroid cancer is rare and often fatal. This review provides an in-depth analysis of 330 clinical cases reported in detail. These data are used to inform a proposal for a hitherto lacking TNM staging system.
Materials and Methods
All case reports or series with sufficient case details of parathyroid cancer were identified from PubMed, and data were analyzed using SPSS.
Results
Of 330 patients, 117 (35%) died of disease and 207 (63%) experienced recurrence in a total of 2007 follow-up years and a mean length of follow-up of 6.1 years. Histopathology findings rather than biochemical or clinical features predict outcome. In univariate analysis, survival and recurrence rates are significantly influenced by gender (male relative risk [RR] 1.7, 95% confidence interval [95% CI] 1.0–2.7,
P
< .01), and presence of vascular invasion (RR 4.3, 95% CI 1.1–17.7,
P
< .01), or lymph node metastases (RR 6.2, 95 %CI 0.9–42.9,
P
< .001). Failure to perform oncological surgery carries a high risk for recurrence and death (local versus
en bloc
resection RR 2.0, CI 1.2–3.2,
P
< .01) as for redo surgery. Staging by a novel anatomy-based TNM system identifies significant outcome variation as to recurrence and death. Separation of patients into low and high risk identifies a 3.5–7.0 fold higher risk of recurrence and death (
P
< .01) for the high-risk group. Distant metastases predominantly target mediastinum and lung.
Conclusion
Understaging and undertreatment are shown to contribute to high recurrence rates and death toll. To improve outcome,
en bloc
resection including central lymph node dissection should be the minimal surgical approach in any patient with suspected parathyroid cancer.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>20221704</pmid><doi>10.1245/s10434-010-1003-6</doi><tpages>19</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2010-08, Vol.17 (8), p.2156-2174 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adult Aged Aged, 80 and over Endocrine Tumors Female Follow-Up Studies Humans Male Medicine Medicine & Public Health Middle Aged Neoplasm Recurrence, Local Neoplasm Staging - methods Oncology Parathyroid Neoplasms - mortality Parathyroid Neoplasms - pathology Risk Factors Surgery Surgical Oncology Survival Rate |
| title | Clinical Presentation, Staging and Long-Term Evolution of Parathyroid Cancer |
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