Sadler Claire, Gow Kenneth W, Beierle Elizabeth A, Doski John J, Langer Monica, Nuchtern Jed G, Vasudevan Sanjeev A, Goldfarb Melanie
Department of Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA.
Division of General and Thoracic Surgery, Seattle Children's Hospital, Seattle, WA.
Surgery. 2014 Dec;156(6):1622-9; discussion 1629-30. doi: 10.1016/j.surg.2014.08.069. Epub 2014 Nov 11.
Parathyroid carcinoma (PC) is a rare malignancy with a moderate prognosis. The staging system, prognostic indicators, and optimal surgical management are still under debate. This large cohort explores prognostic factors for PC.
1,022 cases of PC in the 1998-2011 National Cancer Data Base that underwent surgery were examined for predictors of lower overall survival (OS) and relative risk (RR) of death at 5 years.
The 5-year OS was 81.1% in 528 patients with ≥ 60 months of follow-up. The overall cohort was mainly non-Hispanic (96.5%), white (77.4%), and insured (94.3%), with a median age of 57 years. Mean OS was lower and RR of death greater in older (P < .001), black (P = .007) patients with a secondary malignancy (P = .015) and ≥ 2 comorbidities (P = .005), whose surgical specimen had positive surgical margins (P = .026) or positive lymph nodes (P < .001). Multivariate cox regression demonstrated that positive lymph nodes (hazard ratio [HR], 6.47; 95% CI, 1.81-23.11) and older age (HR, 2.35; 95% CI, 1.25-4.43) were associated with lower OS.
PC is a rare malignancy with a 5-year OS of 81.1%. Positive lymph nodes and older age predict lower OS and an increased risk of death.
甲状旁腺癌（PC）是一种预后中等的罕见恶性肿瘤。其分期系统、预后指标及最佳手术治疗方案仍存在争议。本大型队列研究探讨了甲状旁腺癌的预后因素。
对1998 - 2011年国家癌症数据库中1022例行手术治疗的甲状旁腺癌病例进行分析，以确定总体生存率（OS）较低及5年死亡相对风险（RR）的预测因素。
528例随访时间≥60个月的患者5年总生存率为81.1%。整个队列主要为非西班牙裔（96.5%）、白人（77.4%）且有保险（94.3%），中位年龄为57岁。年龄较大（P <.001）、黑人（P =.007）、患有继发性恶性肿瘤（P =.015）及≥2种合并症（P =.005）、手术标本切缘阳性（P =.026）或淋巴结阳性（P <.001）的患者，其平均总生存率较低，死亡相对风险较高。多因素Cox回归分析显示，淋巴结阳性（风险比[HR]，6.47；95%可信区间[CI]，1.81 - 23.11）和年龄较大（HR，2.35；95% CI，1.25 - 4.43）与较低的总生存率相关。
甲状旁腺癌是一种罕见的恶性肿瘤，5年总生存率为81.1%。淋巴结阳性和年龄较大预示着较低的总生存率和死亡风险增加。
