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Journal of Bone and Mineral Metabolism

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20.02.2022 | Original Article

Mortality factors in recurrent parathyroid cancer: a pooled analysis

verfasst von: Wen-Hsuan Tsai, Yi-Hong Zeng, Chun-Chuan Lee, Ming-Chieh Tsai

Erschienen in: Journal of Bone and Mineral Metabolism | Ausgabe 3/2022

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Abstract

Introduction

Parathyroid cancer is a rare disease with high recurrence rate. The prognostic factors for recurrent parathyroid cancer are yet to be ascertained. We aimed to establish the association between recurrent parathyroid cancer and previously reported prognostic factors.

Materials and methods

We conducted a PubMed search using the keywords ‘parathyroid cancer’, ‘parathyroid neoplasm’, and ‘hypercalcemia’ during 1966–2019 and included 3272 articles. We focused on 73 patients with recurrent parathyroid cancer from 55 studies. We conducted a survival analysis using the Cox proportional hazards model with 95% confidence interval.

Results

For the 73 patients included in the analysis, the mean age (± standard deviation) was 44 ± 13.2 years, wherein 36 patients were women (49.3%). During the 5236 person-months at risk (mean follow-up 71.7 months, range 3–264), 38 patients died. The incidence of local recurrence, lymph-node metastasis, lung metastasis, and bone metastasis were 60.3, 12.3, 56.2, and 24.7, respectively. Bone metastasis, disease-free interval < 1 year, and total surgeries < 3 were significant prognostic factors in univariate analysis (log-rank test P = 0.0063, P = 0.0006, and P = 0.0056, respectively). In the multivariate-adjusted analysis, the mortality risk was significantly increased in patients with bone metastasis with a hazard ratio (HR) of 4.83 (95% CI 1.16–20.2; P = 0.03), disease-free interval <=1 year of 5.92 (95% CI 1.85–18.99; P = 0.003), and total surgeries <3 of 11.29 (95% CI 2.82–45.22; P = 0.001), considering these as possible predictive prognostic factors.

Conclusion

Bone metastasis, duration of disease-free interval, and total number of surgeries predict survival in recurrent parathyroid cancer.

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Titel: Mortality factors in recurrent parathyroid cancer: a pooled analysis
verfasst von: Wen-Hsuan Tsai
Yi-Hong Zeng
Chun-Chuan Lee
Ming-Chieh Tsai
Publikationsdatum: 20.02.2022
Verlag: Springer Nature Singapore
Erschienen in: Journal of Bone and Mineral Metabolism / Ausgabe 3/2022
Print ISSN: 0914-8779
Elektronische ISSN: 1435-5604
DOI: https://doi.org/10.1007/s00774-021-01305-3

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Mortality factors in recurrent parathyroid cancer: a pooled analysis

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