Prognostic Analysis for Patients With Parathyroid Carcinoma: A Population-Based Study.

Front Neurosci

Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Published: February 2022

Background: Parathyroid carcinoma (PC) is a rare but often lethal malignancy for which staging system, prognostic indicators, and treatment guidelines are still not established. We aimed to explore the prognostic parameters and construct a nomogram for cancer-specific survival (CSS) of PC.

Methods: A retrospective analysis of 604 PC patients in the SEER database from 2001 through 2018 was performed. All the cases were randomly assigned to the training cohort ( = 424) or the validation cohort ( = 180) at a ratio of 7:3. The Kaplan-Meier method and Cox regression model were applied to estimate the CSS and risk factors, and a nomogram was constructed. The predictive accuracy and discriminative ability of the nomogram in CSS were assessed by concordance index (C-index), the area under the curve (AUC) of receiver operating characteristics (ROC), and the calibration curve.

Results: Age at diagnosis > 70 years [hazard ratio (HR): 3.55, 95% CI: 1.07-11.78, = 0.039] and tumor size > 35 mm (HR 4.22, 95% CI: 1.67-10.68, = 0.002) were associated with worse CSS. Compared with distant metastasis, localized (HR 0.17, 95% CI: 0.06-0.47, = 0.001) and regional lesions (HR 0.22, 95% CI: 0.07-0.66, = 0.007) showed an improved CSS rate. Parathyroidectomy was the recommended treatment ( = 0.02). The C-index of the nomogram was 0.826, and the AUC for 5-, 10-, and 15-year CSS was 83.7%, 79.7%, and 80.7%, respectively. The calibration curve presented good agreement between prediction by nomogram and actual observation.

Conclusion: Age at diagnosis > 70 years, tumor size > 35 mm, and distant metastasis were independent risk factors for PC-specific mortality. Parathyroidectomy was currently the most recommended treatment for PC. This nomogram provided individualized assessment and reliable prognostic prediction for patients with PC.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8894878PMC
http://dx.doi.org/10.3389/fnins.2022.784599DOI Listing

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