High index of clinical suspicion with optimal surgical techniques and adjuvant radiotherapy is critical to reduce locoregional disease progression in parathyroid carcinoma. | Department of Endocrinology, Diabetes & Metabolism
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Christian Medical College Vellore
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High index of clinical suspicion with optimal surgical techniques and adjuvant radiotherapy is critical to reduce locoregional disease progression in parathyroid carcinoma.

  1. Department of Endocrine Surgery, Christian Medical College, Vellore, India. drckben@gmail.com

American journal of clinical oncology Vol. 36 · Issue 1 · pp. 64-9

PMID 22270105 DOI 10.1097/coc.0b013e31823a4924

Cite This Article

Ben Selvan, Mazhuvenchery J Paul, Mandalam S Seshadri, Nihal Thomas, Thomas Paul, Deepak Abraham, Regi Oommen, Nylla Shandhly, Subhashini John, Simon Rajaratnam, Marie M Therese, Aravindan Nair, Prasanna Kumar Samuel. High index of clinical suspicion with optimal surgical techniques and adjuvant radiotherapy is critical to reduce locoregional disease progression in parathyroid carcinoma. American journal of clinical oncology. 2013;36(1):64-9. doi:10.1097/coc.0b013e31823a4924

Abstract

AIMS: We have analyzed the risk factors and the impact of external beam radiotherapy (EBRT) in reducing the locoregional recurrence of parathyroid carcinoma (PTC).

METHODS: Various parameters such as clinical presentation, intraoperative findings, surgical methods, and usage of parafibromin were analyzed. Selected endpoints were locoregional progression-free survival and overall survival.

RESULTS: Three patients had local recurrence. Two of them received EBRT after the first recurrence but continued to have local recurrence. One patient was lost to follow-up. Six patients with EBRT remain asymptomatic with a locoregional progression-free survival and overall survival of 42 months. The presence of a palpable nodule in the neck, serum calcium >14 mg/dL, and intraoperative substrap adhesion (OR=9.3, 95% confidence interval, 1.76-56.1; P

CONCLUSIONS: PTC should be suspected in the preoperative and intraoperative period. EBRT may reduce local recurrence by 65%. Parafibromin staining with no more than 0 to 1+ intensity in 80% to 100% of cells can predict carcinoma with specificity up to 100%.

Keywords

  • Adult
  • Aged
  • Aged
  • 80 and over
  • Biomarkers
  • Tumor
  • Carcinoma
  • Disease Progression
  • Disease-Free Survival
  • Female
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Neoplasm Recurrence
  • Local
  • Parathyroid Neoplasms
  • Radiotherapy
  • Adjuvant
  • Retrospective Studies
  • Risk Factors
  • Tumor Suppressor Proteins
  • Young Adult
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