Thoracic and GI Oncology Branch, National Cancer Institute, Bethesda, MD, USA.
Endocrine Oncology Branch, National Institutes of Health, Center for Cancer Research, 10 Center Drive, Building 10/CRC 4 W-5950, Bethesda, MD, USA.
Ann Surg Oncol. 2018 Sep;25(9):2535-2540. doi: 10.1245/s10434-018-6559-6. Epub 2018 Jul 3.
The incidence of parathyroid carcinoma is reported to be rising. There is minimal data on prognostic variables associated with cancer-specific survival. The objectives of this study were to evaluate the trends in incidence and assess prognostic factors.
A retrospective review of the SEER database between 1973 and 2014 was performed, identifying 520 patients with parathyroid carcinoma. Population-adjusted incidence rates were calculated in 4-year intervals. A Cochrane-Armitage test was performed to analyze changes in trend in incidence, tumor size, and extent of disease. Age, year of diagnosis, race, gender, extent of disease, surgical resection, treatment with radiation, tumor size, and lymph node status were assessed using Mantel-Cox log rank test. Multivariate analysis was performed by Cox regression analysis.
The incidence of parathyroid carcinoma has been increasing since 1974 from 2 to 11 cases per 10 million people but has since stabilized at 11 cases per 10 million people since 2001. The increasing incidence was attributed to locoregional disease and tumor size < 3 cm. The presence of metastatic disease [hazard ratio (HR) 111.4, 95% confidence interval (CI) 20.6-601.8, p < 0.0001) and tumor size > 3 cm (HR 5.6, 95% CI 1.5-21.2, p = 0.011] were associated with worse cancer-specific survival by univariate and multivariate analyses.
The incidence of parathyroid carcinoma has remained stable over the past decade. Tumor size < 3 cm and regional disease have increased in incidence. Patients with metastatic disease and tumors > 3 cm have worse cancer-specific survival. These findings can be incorporated in the development of a staging system for parathyroid carcinoma.
甲状旁腺癌的发病率据报道正在上升。关于与癌症特异性生存相关的预后变量的数据很少。本研究的目的是评估发病率的趋势并评估预后因素。
对 1973 年至 2014 年 SEER 数据库进行回顾性分析，确定了 520 例甲状旁腺癌患者。以 4 年为间隔计算人口调整后的发病率。采用 Cochrane-Armitage 检验分析发病率、肿瘤大小和疾病程度的变化趋势。采用 Mantel-Cox 对数秩检验评估年龄、诊断年份、种族、性别、疾病程度、手术切除、放疗、肿瘤大小和淋巴结状态。采用 Cox 回归分析进行多变量分析。
自 1974 年以来，甲状旁腺癌的发病率一直在增加，从每 1000 万人中有 2 例增加到 11 例，但自 2001 年以来，每 1000 万人中稳定在 11 例。发病率的增加归因于局部区域疾病和肿瘤大小<3cm。存在转移性疾病[风险比（HR）111.4，95%置信区间（CI）20.6-601.8，p<0.0001]和肿瘤大小>3cm（HR 5.6，95% CI 1.5-21.2，p=0.011）与单变量和多变量分析的癌症特异性生存较差相关。
在过去十年中，甲状旁腺癌的发病率保持稳定。肿瘤大小<3cm 和局部疾病的发病率有所增加。患有转移性疾病和肿瘤>3cm 的患者癌症特异性生存率较差。这些发现可以纳入甲状旁腺癌分期系统的制定。
