A nationwide study on parathyroid carcinoma. (3rd July 2017)
- Record Type:
- Journal Article
- Title:
- A nationwide study on parathyroid carcinoma. (3rd July 2017)
- Main Title:
- A nationwide study on parathyroid carcinoma
- Authors:
- Ryhänen, Eeva M.
Leijon, Helena
Metso, Saara
Eloranta, Eija
Korsoff, Pirkko
Ahtiainen, Petteri
Kekäläinen, Päivi
Tamminen, Marjo
Ristamäki, Raija
Knutar, Otto
Löyttyniemi, Eliisa
Niskanen, Leo
Väisänen, Mika
Heiskanen, Ilkka
Välimäki, Matti J.
Laakso, Markku
Haglund, Caj
Arola, Johanna
Schalin-Jäntti, Camilla - Abstract:
- Abstract: Background: Parathyroid carcinoma (PC) is rare and diagnostically challenging. Reported outcomes are rather poor and the incidence might be increasing. Material and methods: We performed a nationwide study on all cases ( n = 32) diagnosed in 2000–2011 in Finland, and compared clinical and histopathological characteristics and outcome to atypical parathyroid (APA; n = 28) and parathyroid adenomas (PA; n = 72). The incidence in years 1955–1999 was compared to that in 2000–2013. Results: Preoperatively, calcium and parathyroid hormone concentrations were higher in PC compared to APA and PA (1.76, 1.56 and 1.44 mmol/l, p < .001; and 989, 355 and 160 μmol/l, p < .001, respectively). Calcium was ≤1.77 mmol/l for all PAs. Hospitalization (44% vs. 22% and 3%, respectively, p = .01), renal (50% vs. 48% vs. 22%, respectively, p = .01) and bone (47% vs. 15% vs. 38%, respectively p = .002) manifestations were more common. PC and APA tumors were larger than PA ( p < .001). Histopathological characteristics of PC compared to PA are increased mitotic activity ( p = .001), chief cells ( p = .003), diffuse growth pattern ( p < .001), higher Ki67 ( p < .001) and negative parafibromin ( p < .001). One PC (1/18) and one APA (1/16) patient had a CDC73 mutation. After 6.7 (2–13.9) years of follow-up, 9.4% of PC had residual, 21% recurrent disease and 12.5% died of disease. Overall mortality did not differ between subgroups ( p = .094). Recurrent PC was characterized byAbstract: Background: Parathyroid carcinoma (PC) is rare and diagnostically challenging. Reported outcomes are rather poor and the incidence might be increasing. Material and methods: We performed a nationwide study on all cases ( n = 32) diagnosed in 2000–2011 in Finland, and compared clinical and histopathological characteristics and outcome to atypical parathyroid (APA; n = 28) and parathyroid adenomas (PA; n = 72). The incidence in years 1955–1999 was compared to that in 2000–2013. Results: Preoperatively, calcium and parathyroid hormone concentrations were higher in PC compared to APA and PA (1.76, 1.56 and 1.44 mmol/l, p < .001; and 989, 355 and 160 μmol/l, p < .001, respectively). Calcium was ≤1.77 mmol/l for all PAs. Hospitalization (44% vs. 22% and 3%, respectively, p = .01), renal (50% vs. 48% vs. 22%, respectively, p = .01) and bone (47% vs. 15% vs. 38%, respectively p = .002) manifestations were more common. PC and APA tumors were larger than PA ( p < .001). Histopathological characteristics of PC compared to PA are increased mitotic activity ( p = .001), chief cells ( p = .003), diffuse growth pattern ( p < .001), higher Ki67 ( p < .001) and negative parafibromin ( p < .001). One PC (1/18) and one APA (1/16) patient had a CDC73 mutation. After 6.7 (2–13.9) years of follow-up, 9.4% of PC had residual, 21% recurrent disease and 12.5% died of disease. Overall mortality did not differ between subgroups ( p = .094). Recurrent PC was characterized by vascular invasion, lymph node metastases, high mitotic activity, necrosis and negative parafibromin. Incidence increased from 1.42 (range 0.52–2.14) to 7.14 (range 3.42–10.38)/10.000.000/years; ( p < .001). Conclusions: PC associates with severe primary hyperparathyroidism and must be suspected if calcium ≥1.77 mmol/l. The prevalence of CDC73 germline mutations in PC and APA in Finland is 6%. PC has distinct histopathological characteristics and its incidence has increased over the past decades. … (more)
- Is Part Of:
- Acta oncologica. Volume 56:Number 7(2017)
- Journal:
- Acta oncologica
- Issue:
- Volume 56:Number 7(2017)
- Issue Display:
- Volume 56, Issue 7 (2017)
- Year:
- 2017
- Volume:
- 56
- Issue:
- 7
- Issue Sort Value:
- 2017-0056-0007-0000
- Page Start:
- 991
- Page End:
- 1003
- Publication Date:
- 2017-07-03
- Subjects:
- Oncology -- Periodicals
Cancer -- Treatment -- Periodicals
616.992 - Journal URLs:
- http://informahealthcare.com/loi/onc ↗
http://informahealthcare.com ↗ - DOI:
- 10.1080/0284186X.2017.1306103 ↗
- Languages:
- English
- ISSNs:
- 0284-186X
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 0641.705000
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- 2102.xml