Prognostic Analysis for Patients With Parathyroid Carcinoma: A Population-Based Study

Area of Science:

• Endocrinology
• Oncology
• Cancer Research

Background:

• Parathyroid carcinoma (PC) is a rare, aggressive malignancy with undefined prognostic indicators and treatment strategies.
• Existing knowledge gaps hinder effective patient management and survival prediction for PC.

Purpose of the Study:

• To identify independent prognostic factors for cancer-specific survival (CSS) in parathyroid carcinoma.
• To develop and validate a nomogram for predicting CSS in PC patients.

Main Methods:

• Retrospective analysis of 604 PC patients from the SEER database (2001-2018).
• Data split into training (n=424) and validation (n=180) cohorts.
• Kaplan-Meier and Cox regression models used for survival analysis and risk factor identification; nomogram construction and validation via C-index and ROC AUC.

Main Results:

• Age > 70 years and tumor size > 35 mm are associated with worse CSS (HRs 3.55 and 4.22, respectively).
• Localized and regional disease stages show significantly improved CSS compared to distant metastasis (HRs 0.17 and 0.22, respectively).
• Parathyroidectomy demonstrated a significant association with improved CSS (p=0.02); the nomogram achieved a C-index of 0.826.

Conclusions:

• Age, tumor size, and metastatic status are independent predictors of PC-specific mortality.
• Parathyroidectomy is the recommended treatment for PC.
• The developed nomogram offers a reliable tool for individualized prognostic assessment in PC.