Two hundred eighty-six cases of parathyroid carcinoma treated in the US between 1985-1995 - A National Cancer Date Base report

BACKGROUND. In combination with other Commission on Cancer programs, the Na tional Cancer Data Base (NCDB), a national electronic registry system curre ntly capturing > 60% of incident cancers in the U. S., offers a working exa mple of voluntary, accurate, cast-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 col lected demographic, stage, treatment, and outcome information for a nationa l hospital-based sample of 286 parathyroid carcinoma cases (0.005 % of the total NCDB cancer cases). This report describes clinical and demographic fe atures 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. Gend er distribution was equal. The authors were unable to detect any disproport ionate clustering by race, income level, or geographic region. Treatment ov erwhelmingly was surgical. The data from the current study suggest that nei ther tumor size nor lymph node status are significant prognostic factors. O verall relative survival at 5 years and 10 years was 85.5% and 49.1%, respe ctively. CONCLUSIONS. At 5 years of follow-up, and possibly beyond, neither tumor si ze nor lymph node status were found to be significant prognostic factors an d basing a staging system on them would be useless. Although complete, en b loc resection of all tumor represents the best opportunity for cure, a subs tantial proportion of patients fail to receive such treatment. The authors speculate that the rarity of this condition and late intraoperative recogni tion occasionally prevent optimal treatment. (C) 1999 American Cancer Socie ty.