학술논문
Management and surgical treatment of parathyroid carcinoma: a 6-year experience of a single centre of endocrine surgery unit.
Document Type
Academic Journal
Author
Laforgia R; Department of Precision and Regenerative Medicine and Jonic Area (DiMePRe-J), Section of Surgery, Laparoscopic and Emergency General Surgery Unit, Hospital University of Bari, Bari, Italy.; Tomasicchio G; Department of Precision and Regenerative Medicine and Jonic Area (DiMePRe-J), Section of Surgery, Laparoscopic and Emergency General Surgery Unit, Hospital University of Bari, Bari, Italy.; Cavalera F; Department of Precision and Regenerative Medicine and Jonic Area (DiMePRe-J), Section of Surgery, Laparoscopic and Emergency General Surgery Unit, Hospital University of Bari, Bari, Italy.; Sblendorio M; Department of Precision and Regenerative Medicine and Jonic Area (DiMePRe-J), Section of Surgery, Laparoscopic and Emergency General Surgery Unit, Hospital University of Bari, Bari, Italy.; Spadone A; Department of Precision and Regenerative Medicine and Jonic Area (DiMePRe-J), Section of Surgery, Laparoscopic and Emergency General Surgery Unit, Hospital University of Bari, Bari, Italy.; Anelli FM; Department of Precision and Regenerative Medicine and Jonic Area (DiMePRe-J), Section of Surgery, Laparoscopic and Emergency General Surgery Unit, Hospital University of Bari, Bari, Italy.; Lobascio P; Department of Precision and Regenerative Medicine and Jonic Area (DiMePRe-J), Section of Surgery, Laparoscopic and Emergency General Surgery Unit, Hospital University of Bari, Bari, Italy.; Marzaioli R; Department of Precision and Regenerative Medicine and Jonic Area (DiMePRe-J), Section of Surgery, Laparoscopic and Emergency General Surgery Unit, Hospital University of Bari, Bari, Italy.; Panebianco A; Department of Precision and Regenerative Medicine and Jonic Area (DiMePRe-J), Section of Surgery, Laparoscopic and Emergency General Surgery Unit, Hospital University of Bari, Bari, Italy.; Pezzolla A; Department of Precision and Regenerative Medicine and Jonic Area (DiMePRe-J), Section of Surgery, Laparoscopic and Emergency General Surgery Unit, Hospital University of Bari, Bari, Italy.
Source
Publisher: Frontiers Research Foundation] Country of Publication: Switzerland NLM ID: 101555782 Publication Model: eCollection Cited Medium: Print ISSN: 1664-2392 (Print) Linking ISSN: 16642392 NLM ISO Abbreviation: Front Endocrinol (Lausanne) Subsets: MEDLINE
Subject
Language
English
ISSN
1664-2392
Abstract
Background: Parathyroid carcinoma (PC) affects 0.1-0.3% of the general population and represents the rarest malignant neoplasms among endocrinological diseases, comprising less than 1%. The best therapeutic treatment and management methods are still debated in the literature. The aim of this study is to evaluate the management and surgical treatment of parathyroid carcinoma after 6 years of enrolment with the Endocrine Surgery Unit of the University Hospital of Bari.
Materials and Methods: A retrospective observational study was carried out using a prospectively maintained database of patients affected by primary hyperparathyroidism between January 2017 and September 2022. Consecutive patients over 18 years old with a final histopathological finding of PC were included in the study. Patients with secondary or tertiary hyperparathyroidism, parathyroid hyperplasia, and parathyroid adenoma were excluded. All patients underwent follow-up every 6 months for the first 2 years, and annually thereafter.
Results: In this study, 9 out of 40 patients affected by hyperparathyroidism were included; 6 (66.6%) were female and 3 (33.3%) were male patients, with a median age of 59 years (IQR 46-62). None had a family history of PC. No mortality was recorded while the incidence of recurrence was 22.2%, with a disease-free survival of 8 and 10 months. Parathyroidectomy was performed in five patients, while four patients underwent parathyroidectomy with concurrent thyroidectomy for thyroid goitre. No intraoperative complications were recorded. Open parathyroidectomy was performed with a mini-cervicotomy in seven patients, while two patients underwent robotic surgery. All patients were discharged on the second postoperative day.
Conclusion: PC represents a great challenge in terms of preoperative diagnosis, management and treatment. A surgical approach represents the first best option for PC in referral endocrine surgery units. The early identification of risky patients should be the dominant goal to plan an appropriate therapy and to perform adequate en bloc surgery.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2023 Laforgia, Tomasicchio, Cavalera, Sblendorio, Spadone, Anelli, Lobascio, Marzaioli, Panebianco and Pezzolla.)
Materials and Methods: A retrospective observational study was carried out using a prospectively maintained database of patients affected by primary hyperparathyroidism between January 2017 and September 2022. Consecutive patients over 18 years old with a final histopathological finding of PC were included in the study. Patients with secondary or tertiary hyperparathyroidism, parathyroid hyperplasia, and parathyroid adenoma were excluded. All patients underwent follow-up every 6 months for the first 2 years, and annually thereafter.
Results: In this study, 9 out of 40 patients affected by hyperparathyroidism were included; 6 (66.6%) were female and 3 (33.3%) were male patients, with a median age of 59 years (IQR 46-62). None had a family history of PC. No mortality was recorded while the incidence of recurrence was 22.2%, with a disease-free survival of 8 and 10 months. Parathyroidectomy was performed in five patients, while four patients underwent parathyroidectomy with concurrent thyroidectomy for thyroid goitre. No intraoperative complications were recorded. Open parathyroidectomy was performed with a mini-cervicotomy in seven patients, while two patients underwent robotic surgery. All patients were discharged on the second postoperative day.
Conclusion: PC represents a great challenge in terms of preoperative diagnosis, management and treatment. A surgical approach represents the first best option for PC in referral endocrine surgery units. The early identification of risky patients should be the dominant goal to plan an appropriate therapy and to perform adequate en bloc surgery.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2023 Laforgia, Tomasicchio, Cavalera, Sblendorio, Spadone, Anelli, Lobascio, Marzaioli, Panebianco and Pezzolla.)