[Surgical treatment of parathyroid carcinoma : Does the initial en bloc resection improve the prognosis?] / Chirurgie des Nebenschilddrüsenkarzinoms : Verbessert die initiale En-bloc-Resektion die Prognose?
Chirurg
; 90(11): 905-912, 2019 Nov.
Article
em De
| MEDLINE
| ID: mdl-31359113
ABSTRACT
BACKGROUND:
Radical en bloc resection of the tumor with ipsilateral hemithyroidectomy and central lymphadenectomy (PTX+HTX) is currently the generally recommended treatment strategy for parathyroid carcinoma (PC) in Germany; however, it remains unclear whether the en bloc resection leads to a prognostic benefit compared to parathyroidectomy (PTX) alone, especially considering disease-free and overall survival.OBJECTIVE:
This study analyzed the survival of patients with PC after PTX+HTX compared to patients with PTX.METHODS:
Patients with PC were identified from a prospective database and retrospectively analyzed regarding clinicopathological features, surgical treatment, disease-free interval and overall survival.RESULTS:
Out of 1705 patients who were operated on because of primary hyperparathyroidism (pHPT), 18 (1.1%) had histologically confirmed PC. In nine patients PTX+HTX was initially performed and the other nine patients received only PTX. After PTX, all of the nine patients developed a recurrence after a median of 18 months (range 7-84 months), while only one patient had a recurrence after PTX+HTX. After PTX a median three (range 2-18) reoperations were indicated for relapse but after PTX+HTX only one patient had to undergo two relapse surgeries (pâ¯< 0.001). The recurrence-free survival after PTX+HTX was significantly longer than after PTX (143 vs. 18 months, pâ¯= 0.01), while the overall survival of both groups after a median follow-up of 107.5 months did not significantly differ.DISCUSSION:
If there is any clinical suspicion of PC, an en bloc resection should be performed to prolong recurrence-free survival and avoid reoperations.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias das Paratireoides
/
Paratireoidectomia
Idioma:
De
Ano de publicação:
2019
Tipo de documento:
Article