The survival of patients with parathyroid cancer is often fairly long, especially if the initial operation is carried out at a specialized endocrine surgery center, shows a new retrospective study.

The analysis included data from 37 patients who received a primary operation or treatment for a recurrence of parathyroid cancer at the endocrine surgery center of the University of California, San Francisco (UCSF). The data cover a period of 43 years. “To be able to study factors associated with such a rare disease is uncommon,” comments lead author Avital Harari. “We were in a unique position to study this rare disease after so many years.”

The average age of patients at cancer diagnosis was 53 years and their median overall survival was 14.3 years from diagnosis. As a consequence of high recurrence rates after initial cancer operation (49%) and frequent need for re-operations, 60% of patients eventually developed complications of cancer treatment, including laryngeal nerve injury in 38% of patients.

Lymph-node or distant metastases, the number of recurrences, high calcium level at recurrence and use of a high number of calcium-lowering medications were factors independently associated with increased mortality.

Initial operation at UCSF improved survival and decreased complication rates compared with operations done elsewhere. Therefore, the authors believe that if there is a high suspicion of parathyroid cancer, clinicians should consider referring the patient to a surgeon experienced in parathyroid cancer in a center that specializes in endocrine surgery.