ECE2017 Eposter Presentations: Calcium and Bone Endocrine tumours and neoplasia (7 abstracts)
Parathyroid cancer – clinical presentation, prognostic factors and long-term evolution
Beata Jurecka-Lubieniecka 1 , Barbara Michalik 1 , Grzegorz Bula 2 , Jacek Gawrychowski 2 , Dariusz Kajdaniuk 3 , Bogdan Marek 3 , Andrzej Tukiendorf 4 & Barbara Jarzab 1
1Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland; 2Department of General and Endocrinal Surgery, Bytom, Silesian Medical University, Katowice, Poland; 3Department of Pathophysiology and Endocrinology, Silesian Medical University, Katowice, Poland; 4Department of Epidemiology and Silesia Cancer Registry, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland.
Background: Parathyroid carcinoma (PC) is a rare endocrine malignancy affecting 0.5–5% of all patients with primary hyperparathyroidism. Due to the rarity of PC there is still lack of prognostic implications of the disease and clear consensus regarding management. Our purpose was to evaluate prognostic factors and treatment outcomes of patients treated at the Department of Nuclear Medicine and Endocrine Oncology.
Methods: The target group covered 44 patients with parathyroid carcinoma treated in years 1995-2016 at the department of Nuclear Medicine and Endocrine Oncology.
Results: All the patients were treated surgically, 17 of them repeatedly, however, only in 19 patients the en bloc resection was performed, 25 patients underwent only parathyroidectomy. During an average 10-year-observation among all the patients operated non-radically the recurrence of the disease appeared. Deaths occurred only in this group, despite radio- and chemotherapy. An interesting clinical observation are benefits resulting from cinacalcet treatment: taking the medicine for 2–4 years resulted in stabilization and ever remission of the disease in four patients with metastasis. To predict outcome histopathology results, biochemical and clinical features were analyzed. Due to a limited number of patients, a parametric Weibull’s regression was adopted. Among the analyzed risk factors distant metastasis and organ complications, mainly renal failure were statistically crucial in patients survival. Occurrence of distant metastasis increases the risk of early death seven times (HR =6.82, P=0.02) whereas in renal failure the risk increases nine times (HR =8.92, P=0.008).
Conclusions: In patients with parathyroid carcinoma, definition of prognostic factors and the role of the radiation, chemotherapy and cinacalcet treatment still has to be elucidated. In our analysis distant metastases and renal failure were critical factors regarding increased risk of death.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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