Prognostic factors and survival in parathyroid carcinoma: a 50-year single-center cohort study

This study aims to analyze the clinical characteristics and prognostic factors of patients with parathyroid carcinoma (PC) treated at a tertiary institution.

This retrospective cohort included 30 patients with PC who were treated between 1970 and 2023 at a single reference center. Clinical, pathological, and survival data were reviewed and prognostic factors were evaluated.

Of the 30 cases, 16 (53.3%) were women. Mean age at diagnosis was 45.9 years, median follow-up was 60 months and mean tumor size was 33 mm. Median follow-up was 60 months. Disease recurrence occurred in 16 (53.3%) cases, with disease persistence in three (10.0%). Median disease-free survival was 80 months, with a 57% overall survival rate. Neither gender nor age showed significant impact on survival. Patients with lower-stage tumors (T1 by the AJCC/UICC and T1+T2 by the Shaha classification) had significantly better overall survival (p = 0.004 and p = 0.0018, respectively) and disease-free survival (p = 0.03 and p = 0.04, respectively) than those with more advanced stages (p = 0.03 and p = 0.04, respectively). Additionally, patients who experienced tumor recurrence after 36 months had significantly better survival outcomes than those with earlier recurrences (p = 0.02).

Advanced tumor stage (T3 by the Shaha or T2 and above by the AJCC/UICC) is associated with higher mortality in patients with PC. Furthermore, a disease-free interval exceeding 36 months emerged as a relevant factor associated with improved overall survival.