School of Biology and Engineering (School of Health and Medicine Modern Industry), Guizhou Medical University, Guiyang, China.
Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, Hong Kong SAR, China.
Front Endocrinol (Lausanne). 2023 Oct 16;14:1167508. doi: 10.3389/fendo.2023.1167508. eCollection 2023.
Complete resection of the tumor and the ipsilateral thyroid lobe at the primary surgery is the "gold standard" for the treatment of parathyroid carcinoma (PC). However, differences in the overall survival (OS) of patients with PC who underwent partial and total surgical resection remain to be determined.
Data on patients with PC who underwent partial and total surgical resection were extracted from the Surveillance, Epidemiology and End Results (SEER) database (2000-2018). The X-tile software (https://medicine.yale.edu/lab/rimm/research/software/) was used to define the optimal cut-off values for continuous variables. The inverse probability of treatment weighting (IPTW) method was used to reduce the selection bias. IPTW-adjusted Kaplan-Meier curves and Cox proportional hazards models were used to compare the OS of patients with PC in the partial and total surgical resection groups.
A total of 334 patients with PC were included in this study (183 and 151 in the partial and total surgical resection groups, respectively). The optimal cut-off values for age at diagnosis were 53 and 73 years, respectively, while that for tumor size was 34 mm. In both the Kaplan-Meier analysis and univariable Cox proportional hazards regression analysis before IPTW, the difference in OS between the partial and total surgical resection groups was not statistically significant (p>0.05). These findings were confirmed in the IPTW-adjusted Kaplan-Meier analysis and multivariate Cox proportional hazards regression analysis (p>0.05). Subgroup analysis revealed that total surgical resection was beneficial for OS only in the subgroup with unknown tumor size.
There was no significant difference in the prognosis of patients who underwent partial and total surgical resection. This finding may provide a useful reference for the treatment of PC.
在原发性手术中完全切除肿瘤和同侧甲状腺叶是甲状旁腺癌（PC）治疗的“金标准”。然而，接受部分和全切除术的 PC 患者的总生存（OS）差异仍有待确定。
从监测、流行病学和最终结果（SEER）数据库（2000-2018 年）中提取接受部分和全切除术的 PC 患者的数据。使用 X-tile 软件（https://medicine.yale.edu/lab/rimm/research/software/）定义连续变量的最佳截止值。采用逆概率治疗加权（IPTW）方法减少选择偏差。使用 IPTW 调整的 Kaplan-Meier 曲线和 Cox 比例风险模型比较部分和全切除术组 PC 患者的 OS。
本研究共纳入 334 例 PC 患者（部分和全切除术组分别为 183 例和 151 例）。诊断时年龄的最佳截止值分别为 53 岁和 73 岁，肿瘤大小的最佳截止值为 34mm。在 Kaplan-Meier 分析和 IPTW 之前的单变量 Cox 比例风险回归分析中，部分和全切除术组的 OS 差异无统计学意义（p>0.05）。这些发现在 IPTW 调整的 Kaplan-Meier 分析和多变量 Cox 比例风险回归分析中得到了证实（p>0.05）。亚组分析显示，仅在肿瘤大小未知的亚组中，全切除术对 OS 有益。
部分和全切除术的患者预后无显著差异。这一发现可能为 PC 的治疗提供有用的参考。
