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Am J Clin Oncol. 2013 Feb;36(1):64-9. doi: 10.1097/COC.0b013e31823a4924.

High index of clinical suspicion with optimal surgical techniques and adjuvant radiotherapy is critical to reduce locoregional disease progression in parathyroid carcinoma.

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1
Department of Endocrine Surgery, Christian Medical College, Vellore, India. drckben@gmail.com

Abstract

AIMS:

We have analyzed the risk factors and the impact of external beam radiotherapy (EBRT) in reducing the locoregional recurrence of parathyroid carcinoma (PTC).

METHODS:

Various parameters such as clinical presentation, intraoperative findings, surgical methods, and usage of parafibromin were analyzed. Selected endpoints were locoregional progression-free survival and overall survival.

RESULTS:

Three patients had local recurrence. Two of them received EBRT after the first recurrence but continued to have local recurrence. One patient was lost to follow-up. Six patients with EBRT remain asymptomatic with a locoregional progression-free survival and overall survival of 42 months. The presence of a palpable nodule in the neck, serum calcium >14 mg/dL, and intraoperative substrap adhesion (OR=9.3, 95% confidence interval, 1.76-56.1; P<0.05) should raise suspicion. Four of 5 patients showed a predominantly negative staining with parafibromin.

CONCLUSIONS:

PTC should be suspected in the preoperative and intraoperative period. EBRT may reduce local recurrence by 65%. Parafibromin staining with no more than 0 to 1+ intensity in 80% to 100% of cells can predict carcinoma with specificity up to 100%.

PMID:
22270105
DOI:
10.1097/COC.0b013e31823a4924
[Indexed for MEDLINE]
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