Al Asadi Hala, Najah Haythem, Greenberg Jacques A, Greenspun Benjamin, Salehi Niloufar, Aykan Dilay, Finnerty Brendan M, Fahey Thomas J, Zarnegar Rasa
Division of Endocrine and Minimally Invasive Surgery, Department of Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA.
Department of Digestive and Endocrine Surgery, Orleans University Hospital Center, Orleans, France.
Ann Surg Oncol. 2025 Aug 13. doi: 10.1245/s10434-025-18036-8.
The effect of adjuvant radiotherapy (AR) on disease-specific survival (DSS) in patients with parathyroid carcinoma remains unclear. We explored the impact of AR on DSS.
Patients with parathyroid carcinoma were identified in SEER and categorized based on AR administration. To address confounding factors affecting the nonrandom allocation of radiotherapy, we conducted propensity score matching. We then employed Kaplan-Meier survival analysis to estimate DSS.
In total, 549 patients were included, with 64 (11.6%) receiving AR. Those who received AR had larger tumors, measuring 3.2 (interquartile range 2.3-4.5) cm compared with 2.7 (interquartile range 1.8-3.5) cm than those who did not receive AR (p = 0.01). Patients who received AR exhibited improved 10- (90.3% vs. 72.2%, p = 0.02) and 20 year DSS (90% vs. 68%, p = 0.03). Our multivariable Cox regression confirmed that patients who did not receive AR had poorer DSS [3.2, 95% CI 1.3-10.1]. Furthermore, non-Hispanic ethnicity [Hispanic patients: 0.13, 95% CI 0.007-0.7], extraparathyroidal extension (EPE) [2.7, 95% CI 1.1-6.9], and positive lymph node status [10.2, 95% CI 1.6-47.8] were linked to diminished DSS.
Using propensity-score matching in a large database, AR in patients with parathyroid carcinoma was associated with improved DSS compared with matched patients who did not receive AR. Notably, the lack of AR administration was identified as an independent factor linked to poorer DSS [3.2, 95% CI 1.3-10.1]. These findings indicate that AR should be considered by clinicians when dealing with these rare tumors and prospective studies are warranted to further assess its role.
辅助放疗（AR）对甲状旁腺癌患者疾病特异性生存率（DSS）的影响尚不清楚。我们探讨了AR对DSS的影响。
在监测、流行病学与最终结果（SEER）数据库中识别出甲状旁腺癌患者，并根据是否接受AR进行分类。为解决影响放疗非随机分配的混杂因素，我们进行了倾向评分匹配。然后采用Kaplan-Meier生存分析来估计DSS。
总共纳入了549例患者，其中64例（11.6%）接受了AR。接受AR的患者肿瘤更大，大小为3.2（四分位间距2.3 - 4.5）厘米，而未接受AR的患者肿瘤大小为2.7（四分位间距1.8 - 3.5）厘米（p = 0.01）。接受AR的患者10年（90.3%对72.2%，p = 0.02）和20年DSS（90%对68%，p = 0.03）有所改善。我们的多变量Cox回归证实，未接受AR的患者DSS较差[3.2，95%置信区间1.3 - 10.1]。此外，非西班牙裔种族[西班牙裔患者：0.13，95%置信区间0.007 - 0.7]、甲状旁腺外侵犯（EPE）[2.7，95%置信区间1.1 - 6.9]和阳性淋巴结状态[10.2，95%置信区间1.6 - 47.8]与DSS降低有关。
在大型数据库中使用倾向评分匹配，与未接受AR的匹配患者相比，甲状旁腺癌患者接受AR与改善的DSS相关。值得注意的是，未进行AR治疗被确定为与较差DSS相关的独立因素[3.2，95%置信区间1.3 - 10.1]。这些发现表明，临床医生在处理这些罕见肿瘤时应考虑AR，并且有必要进行前瞻性研究以进一步评估其作用。
