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<p>To identify parathyroid carcinoma patients who may be eligible for conservative surgery in the form of primary tumor resection while maintaining oncological safety. Clinical and pathological data were extracted from parathyroid carcinoma cases in the Surveillance, Epidemiology, and End Results database (2000–2021) and Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (2013–2024). The primary outcome of this study was disease-specific survival (DSS). Univariate and multivariate Cox proportional hazards models were constructed to identify factors independently associated with DSS; these factors were then used to define risk-based stratification criteria for surgical comparison. DSS was compared between patients undergoing primary tumor resection and those undergoing en-bloc resection using Kaplan–Meier analysis after propensity score matching. A total of 451 patients were included, with a median follow-up duration of 90.0&#xa0;months. Multivariate analysis revealed that tumor size &gt; 30&#xa0;mm and the presence of distant metastasis were independent predictors of worse DSS. In the matched cohort of patients with tumor size ≤ 30&#xa0;mm and no regional lymph node metastasis, no significant survival difference was observed between the primary tumor resection and en-bloc resection groups (DSS: <i>p</i> = 0.513). In patients with parathyroid carcinoma, the presence of tumors &gt; 30&#xa0;mm in size or distant metastasis suggests poor prognosis. Cases with a tumor size ≤ 30&#xa0;mm and no regional lymph node metastasis may be optimal candidates for the primary tumor resection approach.</p>

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Identifying parathyroid carcinoma patients eligible for conservative surgery in the form of primary tumor resection while maintaining oncological safety

  • 期刊论文

  • 发表日期：

    2026年1月19日

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  • Ziyi Chen,
  • Ting Yan,
  • Wangwang Qiu,
  • Huaiyu Weng,
  • Yufan Tang,
  • Jianyong Lv,
  • Xiaolei Yi,
  • Youben Fan,
  • Zhili Yang

摘要

To identify parathyroid carcinoma patients who may be eligible for conservative surgery in the form of primary tumor resection while maintaining oncological safety. Clinical and pathological data were extracted from parathyroid carcinoma cases in the Surveillance, Epidemiology, and End Results database (2000–2021) and Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (2013–2024). The primary outcome of this study was disease-specific survival (DSS). Univariate and multivariate Cox proportional hazards models were constructed to identify factors independently associated with DSS; these factors were then used to define risk-based stratification criteria for surgical comparison. DSS was compared between patients undergoing primary tumor resection and those undergoing en-bloc resection using Kaplan–Meier analysis after propensity score matching. A total of 451 patients were included, with a median follow-up duration of 90.0 months. Multivariate analysis revealed that tumor size > 30 mm and the presence of distant metastasis were independent predictors of worse DSS. In the matched cohort of patients with tumor size ≤ 30 mm and no regional lymph node metastasis, no significant survival difference was observed between the primary tumor resection and en-bloc resection groups (DSS: p = 0.513). In patients with parathyroid carcinoma, the presence of tumors > 30 mm in size or distant metastasis suggests poor prognosis. Cases with a tumor size ≤ 30 mm and no regional lymph node metastasis may be optimal candidates for the primary tumor resection approach.