Clinical characteristics and treatment outcomes of parathyroid carcinoma: A retrospective review of 234 cases

Wang,Peisong; Xue,Shuai; Wang,Shuo; Lv,Zhi; Meng,Xianying; Wang,Guimin; Meng,Wei; Liu,Jia; Chen,Guang

doi:10.3892/ol.2017.7076

December-2017 Volume 14 Issue 6

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

December-2017 Volume 14 Issue 6

Full Size Image

Article Open Access

Clinical characteristics and treatment outcomes of parathyroid carcinoma: A retrospective review of 234 cases

Authors:
- Peisong Wang
- Shuai Xue
- Shuo Wang
- Zhi Lv
- Xianying Meng
- Guimin Wang
- Wei Meng
- Jia Liu
- Guang Chen
View Affiliations / Copyright

Affiliations: Department of Thyroid Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China, Department of Orthopedics, China‑Japan Union Hospital of Jilin University, Changchun, Jilin 130021, P.R. China

Copyright: © Wang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 7276-7282
|
Published online on: September 27, 2017

https://doi.org/10.3892/ol.2017.7076
Expand metrics +

Abstract

Parathyroid carcinoma (PC) is one of the rarest known types of cancer and has a moderate prognosis, with estimated 5‑ and 10‑year overall survival rates between 78‑85% and between 49‑70%, respectively. To raise awareness of this disease, and to optimize its diagnosis, clinical management and prognosis, the present study retrospectively reviewed 234 cases of PC. A total of 226 cases of PC, which were archived between 1984 and 2015 in the three major databases of the Chinese population, were retrieved and pooled with the 8 cases diagnosed and treated at the Department of Thyroid Surgery of The First Hospital of Jilin University (Changchun, China) between June 2008 and December 2015. The clinicopathological features, diagnosis, surgical procedures and outcomes of these cases of PC were investigated. The review revealed that misdiagnosis has been a considerable issue, with >80% of the patients misdiagnosed prior to surgery, and the accuracy of intraoperative diagnosis based on frozen sections was only 15.04%. The use of radical resection as first‑line therapy significantly improved the disease‑free survival by ~8 years (log‑rank, 20.956; P<0.001); and, at relapse, reoperation prolonged patient survival by ~7 years (log‑rank, 35.322; P<0.001). Consistently, a Cox proportional hazards analysis indicated that radical resection as a first‑line therapy reduced the risk of postoperative recurrence (P=0.030), and that reoperation following recurrence significantly improved patient survival (P=0.030). The 5‑ and 10‑year cumulative disease‑specific survival rates of the cases of PC were 83 and 67%, respectively. Notably, an increased mortality rate was observed among males with PC compared with female patients with PC. In summary, in the past 32 years (1984‑2015), the majority of patients with PC have been misdiagnosed. Performing radical resection as the first‑line therapy significantly reduces recurrence and improves patient survival time; and, following relapse, subsequent surgery has also been demonstrated to be an effective approach.

View Figures

View References

1	Shane E: Clinical review 122: Parathyroid carcinoma. J Clin Endocrinol Metab. 86:485–493. 2001. View Article : Google Scholar : PubMed/NCBI
2	Mori H, Okada Y, Arao T and Tanaka Y: Case of parathyroid carcinoma with a highly aggressive clinical course. J UOEH. 36:243–249. 2014. View Article : Google Scholar : PubMed/NCBI
3	Sadler C, Gow KW, Beierle EA, Doski JJ, Langer M, Nuchtern JG, Vasudevan SA and Goldfarb M: Parathyroid carcinoma in more than 1,000 patients: A population-level analysis. Surgery. 156:1622–1630. 2014. View Article : Google Scholar : PubMed/NCBI
4	Asare EA, Sturgeon C, Winchester DJ, Liu L, Palis B, Perrier ND, Evans DB, Winchester DP and Wang TS: Parathyroid carcinoma: An update on treatment outcomes and prognostic factors from the national cancer data base (NCDB). Ann Surg Oncol. 22:3990–3995. 2015. View Article : Google Scholar : PubMed/NCBI
5	Marcocci C, Cetani F, Rubin MR, Silverberg SJ, Pinchera A and Bilezikian JP: Parathyroid carcinoma. J Bone Miner Res. 23:1869–1880. 2008. View Article : Google Scholar : PubMed/NCBI
6	Koea JB and Shaw JH: Parathyroid cancer: Biology and management. Surg Oncol. 8:155–165. 1999. View Article : Google Scholar : PubMed/NCBI
7	Busaidy NL, Jimenez C, Habra MA, Schultz PN, El-Naggar AK, Clayman GL, Asper JA, Diaz EM Jr, Evans DB, Gagel RF, et al: Parathyroid carcinoma: A 22-year experience. Head Neck. 26:716–726. 2004. View Article : Google Scholar : PubMed/NCBI
8	Givi B and Shah JP: Parathyroid carcinoma. Clin Oncol (R Coll Radiol). 22:498–507. 2010. View Article : Google Scholar : PubMed/NCBI
9	Mohebati A, Shaha A and Shah J: Parathyroid carcinoma: Challenges in diagnosis and treatment. Hematol Oncol Clin North Am. 26:1221–1238. 2012. View Article : Google Scholar : PubMed/NCBI
10	Schott M, Feldkamp J, Schattenberg D, Krueger T, Dotzenrath C, Seissler J and Scherbaum WA: Induction of cellular immunity in a parathyroid carcinoma treated withtumor lysate-pulsed dendritic cells. Eur J Endocrinol. 142:300–306. 2000. View Article : Google Scholar : PubMed/NCBI
11	Bradwell AR and Harvey TC: Control of hypercalcaemia of parathyroid carcinoma by immunisation. Lancet. 353:370–373. 1999. View Article : Google Scholar : PubMed/NCBI
12	Wang L, Han D, Chen W, Zhang S, Wang Z, Li K, Gao Y, Zou S and Yang A: Non-functional parathyroid carcinoma: A case report and review of the literature. Cancer Biol Ther. 16:1569–1576. 2015. View Article : Google Scholar : PubMed/NCBI
13	Zhang J, Tong F, Zhong W and Li S: A case report of anti-parathyroid hormone immunotherapy for parathyroid carcinoma. J Diabetes Endocrinol. 2:36–40. 2011.
14	Siu WK, Law CY, Lam CW, Mak CM, Wong GW, Ho AY, Ho KY, Loo KT, Chiu SC, Chow LT, et al: Novel nonsense CDC73 mutations in Chinese patients with parathyroid tumors. Fam Cancer. 10:695–699. 2011. View Article : Google Scholar : PubMed/NCBI
15	Zhao J, Hu Y, Liao Q, Niu Z, Xing X, Xia W and Zhao Y: Gene identification of potential malignant parathyroid tumors phenotype in Chinese population. Endocr J. 61:597–605. 2014. View Article : Google Scholar : PubMed/NCBI
16	Cao J, Chen C, Wang QL, Xu JJ and Ge MH: Parathyroid carcinoma: A report of six cases with a brief review of the literature. Oncol Lett. 10:3363–3368. 2015.PubMed/NCBI
17	McClenaghan F and Qureshi YA: Parathyroid cancer. Gland Surg. 4:329–338. 2015.PubMed/NCBI
18	Harari A, Waring A, Fernandez-Ranvier G, Hwang J, Suh I, Mitmaker E, Shen W, Gosnell J, Duh QY and Clark O: Parathyroid carcinoma: A 43-year outcome and survival analysis. J Clin Endocrinol Metab. 96:3679–3686. 2011. View Article : Google Scholar : PubMed/NCBI
19	Dąbrowska A, Tarach J and Zwolak A: Primary hyperparathyroidism due to parathyroid cancer-a diagnostic and management challenge. Endokrynol Pol. 66(150): 157–167. 2015.
20	Talat N and Schulte KM: Clinical presentation, staging and long-term evolution of parathyroid cancer. Ann Surg Oncol. 17:2156–2174. 2010. View Article : Google Scholar : PubMed/NCBI
21	Villar-del-Moral J, Jiménez-García A, Salvador-Egea P, Martos-Martínez JM, Nuño-Vázquez-Garza JM, Serradilla-Martín M, Gómez-Palacios A, Moreno-Llorente P, Ortega-Serrano J and de la Quintana-Basarrate A: Prognostic factors and staging systems in parathyroid cancer: A multicenter cohort study. Surgery. 156:1132–1144. 2014. View Article : Google Scholar : PubMed/NCBI
22	Schwartz GG and Sahmoun AE: Ovarian cancer incidence in the United States in relation to manufacturing industry. Int J Gynecol Cancer. 24:247–251. 2014. View Article : Google Scholar : PubMed/NCBI
23	Stevens RG: Working against our endogenous circadian clock: Breast cancer and electric lighting in the modern world. Mutat Res. 680:106–108. 2009. View Article : Google Scholar : PubMed/NCBI
24	Duan K and Mete Ö: Parathyroid Carcinoma: Diagnosis and Clinical Implications. Turk Patoloji Derg. 31 Suppl 1:S80–S97. 2015.
25	Kassahun WT and Jonas S: Focus on parathyroid carcinoma. Int J Surg. 9:13–19. 2011. View Article : Google Scholar : PubMed/NCBI
26	DeLellis RA: Parathyroid carcinoma: An overview. Adv Anat Pathol. 12:53–61. 2005. View Article : Google Scholar : PubMed/NCBI
27	Okamoto T, Iihara M, Obara T and Tsukada T: Parathyroid carcinoma: Etiology, diagnosis, and treatment. World J Surg. 33:2343–2354. 2009. View Article : Google Scholar : PubMed/NCBI
28	Gill AJ: Understanding the genetic basis of parathyroid carcinoma. Endocr Pathol. 25:30–34. 2014. View Article : Google Scholar : PubMed/NCBI
29	Erovic BM, Harris L, Jamali M, Goldstein DP, Irish JC, Asa SL and Mete O: Biomarkers of parathyroid carcinoma. Endocr Pathol. 23:221–231. 2012. View Article : Google Scholar : PubMed/NCBI
30	Kebebew E, Arici C, Duh QY and Clark OH: Localization and reoperation results for persistent and recurrent parathyroid carcinoma. Arch Surg. 136:878–885. 2001. View Article : Google Scholar : PubMed/NCBI
31	Munson ND, Foote RL, Northcutt RC, Tiegs RD, Fitzpatrick LA, Grant CS, van Heerden JA, Thompson GB and Lloyd RV: Parathyroid carcinoma: Is there a role for adjuvant radiation therapy? Cancer. 98:2378–2384. 2003. View Article : Google Scholar : PubMed/NCBI
32	Owen RP, Silver CE, Pellitteri PK, Shaha AR, Devaney KO, Werner JA, Rinaldo A and Ferlito A: Parathyroid carcinoma: A review. Head Neck. 33:429–436. 2011.PubMed/NCBI
33	Obara T and Fujimoto Y: Diagnosis and treatment of patients with parathyroid carcinoma: An update and review. World J Surg. 15:738–744. 1991. View Article : Google Scholar : PubMed/NCBI
34	Qiu ZL, Wu CG, Zhu RS, Xue YL and Luo QY: Unusual case of solitary functioning bone metastasis from a ‘parathyroid adenoma’: Imagiologic diagnosis and treatment with percutaneous vertebroplasty-case report and literature review. J Clin Endocrinol Metab. 98:3555–3561. 2013. View Article : Google Scholar : PubMed/NCBI
35	Hundley JC, Albertson DA, Bradley RF and Levine EA: Resection of pulmonary metastasis from parathyroid carcinoma. Am Surg. 69:779–783. 2003.PubMed/NCBI
36	Iihara M, Okamoto T, Suzuki R, Kawamata A, Nishikawa T, Kobayashi M and Obara T: Functional parathyroid carcinoma: Long-term treatment outcome and risk factor analysis. Surgery. 142:936–943.e1. 2007. View Article : Google Scholar : PubMed/NCBI