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Two hundred eighty‐six cases of parathyroid carcinoma treated in the U.S. between 1985–1995
Author(s) -
Hundahl Scott A.,
Fleming Irvin D.,
Fremgen Amy M.,
Menck Herman R.
Publication year - 1999
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19990801)86:3<538::aid-cncr25>3.0.co;2-k
Subject(s) - medicine , relative survival , cancer , lymph node , cancer registry , stage (stratigraphy) , demography , surgery , sociology , paleontology , biology
BACKGROUND In combination with other Commission on Cancer programs, the National Cancer Data Base (NCDB), a national electronic registry system currently capturing > 60% of incident cancers in the U. S., offers a working example of voluntary, accurate, cost‐effective “outcomes management” on a both a local and national scale. In addition, it is proving to be of particular value in capturing clinical information concerning rare cancers. METHODS For accession years 1985–1995, the NCDB captured prospectively collected demographic, stage, treatment, and outcome information for a national hospital‐based sample of 286 parathyroid carcinoma cases (0.005 % of the total NCDB cancer cases). This report describes clinical and demographic features as well as patterns of care and 5‐year and 10‐year relative survival rates. RESULTS The NCDB's 10‐year accrual of parathyroid carcinoma cases exceeded the cumulative number reported in the English literature though 1991. Gender distribution was equal. The authors were unable to detect any disproportionate clustering by race, income level, or geographic region. Treatment overwhelmingly was surgical. The data from the current study suggest that neither tumor size nor lymph node status are significant prognostic factors. Overall relative survival at 5 years and 10 years was 85.5% and 49.1%, respectively. CONCLUSIONS At 5 years of follow‐up, and possibly beyond, neither tumor size nor lymph node status were found to be significant prognostic factors and basing a staging system on them would be useless. Although complete, en bloc resection of all tumor represents the best opportunity for cure, a substantial proportion of patients fail to receive such treatment. The authors speculate that the rarity of this condition and late intraoperative recognition occasionally prevent optimal treatment. [See editorial on pages 378–80, this issue.] Cancer 1999;86:538–44. © 1999 American Cancer Society.