Subhasis Misra
Brandon Regional Hospital, USA
Title: Parathyroid carcinoma: A population-based clinical outcomes study involving 609 patients from the surveillance epidemiology and end result (SEER) database (1975–2016)
Biography
Biography: Subhasis Misra
Abstract
Introduction: Parathyroid cancer (PC) is an extremely uncommon malignancy with a frequency of 0.005% of all the malignancies and also contributes almost 0.74%-4.7% of all the hyperparathyroidism. Most of the manifestations of the PC are mainly secondary to its complications, including hypercalcemia, nephrolithiasis, peptic ulcer disease (PUD), and bone pathologies. Most of the data related to this rare disease is limited to case series and very few database studies. To the best of our knowledge, we present the largest database study which aims to investigate the demographic, clinical, and pathological factors impacting prognosis and survival of PC.
Methods: Demographic and clinical data of 609 patients with PC was abstracted from the Surveillance Epidemiology and End Result (SEER) database (1975 – 2016). Chi-square test, paired t-test, and cox regression multivariate analysis was used to analyze the data.
Results: The PC had a higher incidence amongst males (52.2%, p<0.005), Caucasians (75.4%, p<0.005), and had a mean age of diagnosis 62±10 years. When grading information was reported, most of the PC was the well-differentiated tumors (Grade 1) (9.3 %) and had Adenocarcinoma NOS histological type (99.7%), p=<0.005. When reported, most of PC were 2-4cm cm in size (56.6 %) and were localized to the gland (65.5 %), p=<0.001. Lymph nodes were only positive in 2.3 % of the entire cohort. Most PC patients were treated surgically (97.2%), followed by the radiation alone (12%), and very few patients received chemotherapy (0.9 %). The 5-year overall observed survival for PC was 82.7 %, while those who underwent surgery only and radiation alone had a 5- year survival of 83.8 %, and 72.2 %, respectively, P=0.037. Multivariate analysis identified age, gender, distant spread, and poorly differentiated histology poorly differentiated grade to be independently associated with increased mortality for PC, p<0.001.
Conclusion: PC is a rare tumor that mostly affects patients in their 6th decade and primarily affects men and Caucasians. Surgical resection offers the optimal survival advantage, while the radiation alone or in combination with surgery does not
provide added survival benefits. To understand better the pathogenesis and factors impacting the survival, all patients diagnosed with PC should be enrolled in a large-scale to the national and international registries.