Recurrence and mortality rate in an Italian multi-center case series of parathyroid atypical adenomas and carcinomas
IntroductionThere are few data regarding the clinical outcome of patients with parathyroid carcinoma (PC) and atypical adenoma (AA) after surgery. Aim of our study was to investigate disease recurrence and mortality rate as well as their predictors in a series of patients with PC or AA.MethodsClinic...
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1158474/full |
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| author | Marco Barale Alice Nervo Andrea Craparo Alessia Pusterla Francesca Retta Federica Maiorino Elena Castellano Alessandro Piovesan Laura Gianotti Giorgio Borretta Massimo Procopio Emanuela Arvat |
| author_facet | Marco Barale Alice Nervo Andrea Craparo Alessia Pusterla Francesca Retta Federica Maiorino Elena Castellano Alessandro Piovesan Laura Gianotti Giorgio Borretta Massimo Procopio Emanuela Arvat |
| author_sort | Marco Barale |
| collection | DOAJ |
| description | IntroductionThere are few data regarding the clinical outcome of patients with parathyroid carcinoma (PC) and atypical adenoma (AA) after surgery. Aim of our study was to investigate disease recurrence and mortality rate as well as their predictors in a series of patients with PC or AA.MethodsClinical and biochemical parameters, histological features, incidence of disease recurrence and mortality rate were retrospectively assessed in 39 patients (51% males, mean age 56.2 ± 17.2 years) diagnosed with PC (n=24) or AA (n=15) and followed up for 6.8 ± 5.0 years after surgery.ResultsNo differences in baseline characteristics were registered between the two groups, except for higher KI67 values in PC than AA (6.9 ± 3.9% vs 3.4 ± 2.1%, p<0.01). Eight patients (21%) experienced recurrence after a mean follow-up of 5.1 ± 2.7 years, with higher relapse rate in PC than AA (25% vs 13%), though this difference did not reach statistical significance. Mortality rate was 10% in the whole sample, without significant differences between PC and AA. Relapsing cases had been undergone the most extensive surgery more frequently and they had a higher mortality rate in comparison to non relapsing patients (38% vs 6% and 38% vs 3%, respectively, p<0.03 for both). In comparison to survivors, deceased patients were submitted to the most extensive surgery more frequently (50% vs 9%), they were older (74.8 ± 4.6 vs 53.2 ± 16.3 years), and they had higher KI67 values (11.7 ± 4.9 vs 4.8 ± 2.8, p<0.03 for all comparisons).ConclusionsDuring seven-year follow-up after surgery, no significant differences in recurrence and mortality rate were observed between PC and AA patients. Death was associated with disease relapse, older age and higher KI67 values. These findings suggest a similar and careful long-term follow-up in both parathyroid tumors, especially in older patients, and emphasize the need of further studies in large cohorts to throw light on this crucial clinical issue. |
| first_indexed | 2024-04-09T13:56:31Z |
| format | Article |
| id | doaj.art-202ddf1da94747669570efde95f13f69 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-09T13:56:31Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-202ddf1da94747669570efde95f13f692023-05-08T04:36:26ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-05-011410.3389/fendo.2023.11584741158474Recurrence and mortality rate in an Italian multi-center case series of parathyroid atypical adenomas and carcinomasMarco Barale0Alice Nervo1Andrea Craparo2Alessia Pusterla3Francesca Retta4Federica Maiorino5Elena Castellano6Alessandro Piovesan7Laura Gianotti8Giorgio Borretta9Massimo Procopio10Emanuela Arvat11Division of Endocrinology, Diabetology and Metabolic Diseases, Department of Medical Sciences, Città Della Salute e Della Scienza Hospital, University of Turin - Cso Dogliotti, Turin, ItalyOncological Endocrinology Unit, Department of Medical Sciences, Città Della Salute e Della Scienza Hospital, University of Turin - Via Genova, Turin, ItalyDivision of Endocrinology, Diabetology and Metabolic Diseases, Department of Medicine, A. O. Santa Croce e Carle - S.Croce Hospital - Via Coppino, Cuneo, ItalyDivision of Endocrinology, Diabetology and Metabolic Diseases, Department of Medical Sciences, Città Della Salute e Della Scienza Hospital, University of Turin - Cso Dogliotti, Turin, ItalyOncological Endocrinology Unit, Department of Medical Sciences, Città Della Salute e Della Scienza Hospital, University of Turin - Via Genova, Turin, ItalyDivision of Endocrinology, Diabetology and Metabolic Diseases, Department of Medical Sciences, Città Della Salute e Della Scienza Hospital, University of Turin - Cso Dogliotti, Turin, ItalyDivision of Endocrinology, Diabetology and Metabolic Diseases, Department of Medicine, A. O. Santa Croce e Carle - S.Croce Hospital - Via Coppino, Cuneo, ItalyOncological Endocrinology Unit, Department of Medical Sciences, Città Della Salute e Della Scienza Hospital, University of Turin - Via Genova, Turin, ItalyDivision of Endocrinology, Diabetology and Metabolic Diseases, Department of Medicine, A. O. Santa Croce e Carle - S.Croce Hospital - Via Coppino, Cuneo, ItalyDivision of Endocrinology, Diabetology and Metabolic Diseases, Department of Medicine, A. O. Santa Croce e Carle - S.Croce Hospital - Via Coppino, Cuneo, ItalyDivision of Endocrinology, Diabetology and Metabolic Diseases, Department of Medical Sciences, Città Della Salute e Della Scienza Hospital, University of Turin - Cso Dogliotti, Turin, ItalyOncological Endocrinology Unit, Department of Medical Sciences, Città Della Salute e Della Scienza Hospital, University of Turin - Via Genova, Turin, ItalyIntroductionThere are few data regarding the clinical outcome of patients with parathyroid carcinoma (PC) and atypical adenoma (AA) after surgery. Aim of our study was to investigate disease recurrence and mortality rate as well as their predictors in a series of patients with PC or AA.MethodsClinical and biochemical parameters, histological features, incidence of disease recurrence and mortality rate were retrospectively assessed in 39 patients (51% males, mean age 56.2 ± 17.2 years) diagnosed with PC (n=24) or AA (n=15) and followed up for 6.8 ± 5.0 years after surgery.ResultsNo differences in baseline characteristics were registered between the two groups, except for higher KI67 values in PC than AA (6.9 ± 3.9% vs 3.4 ± 2.1%, p<0.01). Eight patients (21%) experienced recurrence after a mean follow-up of 5.1 ± 2.7 years, with higher relapse rate in PC than AA (25% vs 13%), though this difference did not reach statistical significance. Mortality rate was 10% in the whole sample, without significant differences between PC and AA. Relapsing cases had been undergone the most extensive surgery more frequently and they had a higher mortality rate in comparison to non relapsing patients (38% vs 6% and 38% vs 3%, respectively, p<0.03 for both). In comparison to survivors, deceased patients were submitted to the most extensive surgery more frequently (50% vs 9%), they were older (74.8 ± 4.6 vs 53.2 ± 16.3 years), and they had higher KI67 values (11.7 ± 4.9 vs 4.8 ± 2.8, p<0.03 for all comparisons).ConclusionsDuring seven-year follow-up after surgery, no significant differences in recurrence and mortality rate were observed between PC and AA patients. Death was associated with disease relapse, older age and higher KI67 values. These findings suggest a similar and careful long-term follow-up in both parathyroid tumors, especially in older patients, and emphasize the need of further studies in large cohorts to throw light on this crucial clinical issue.https://www.frontiersin.org/articles/10.3389/fendo.2023.1158474/fullparathyroid atypical adenomaparathyroid carcinomarecurrencemortalityki67follow up |
| spellingShingle | Marco Barale Alice Nervo Andrea Craparo Alessia Pusterla Francesca Retta Federica Maiorino Elena Castellano Alessandro Piovesan Laura Gianotti Giorgio Borretta Massimo Procopio Emanuela Arvat Recurrence and mortality rate in an Italian multi-center case series of parathyroid atypical adenomas and carcinomas Frontiers in Endocrinology parathyroid atypical adenoma parathyroid carcinoma recurrence mortality ki67 follow up |
| title | Recurrence and mortality rate in an Italian multi-center case series of parathyroid atypical adenomas and carcinomas |
| title_full | Recurrence and mortality rate in an Italian multi-center case series of parathyroid atypical adenomas and carcinomas |
| title_fullStr | Recurrence and mortality rate in an Italian multi-center case series of parathyroid atypical adenomas and carcinomas |
| title_full_unstemmed | Recurrence and mortality rate in an Italian multi-center case series of parathyroid atypical adenomas and carcinomas |
| title_short | Recurrence and mortality rate in an Italian multi-center case series of parathyroid atypical adenomas and carcinomas |
| title_sort | recurrence and mortality rate in an italian multi center case series of parathyroid atypical adenomas and carcinomas |
| topic | parathyroid atypical adenoma parathyroid carcinoma recurrence mortality ki67 follow up |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1158474/full |
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