We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
INTEGRA BIOSCIENCES AG

Download Mobile App




Prognostic Tool Stratifies Risk of Parathyroid Carcinoma

By LabMedica International staff writers
Posted on 09 May 2017
Print article
Image: Researchers have identified key predictors of PTC recurrence after surgery, and developed a system to identify patients at the highest risk of recurrence (Photo courtesy of HealthTap).
Image: Researchers have identified key predictors of PTC recurrence after surgery, and developed a system to identify patients at the highest risk of recurrence (Photo courtesy of HealthTap).
Researchers have identified key predictors of parathyroid cancer (PTC) recurrence after surgery, and developed a 3-point scoring system to more reliably identify patients at the highest risk of recurrence. Consequently, the tool can also help determine optimal postoperative strategy.

The best chance for cure of PTC is early diagnosis then surgical removal of all tumor cells. However, over 50% of patients develop a recurrence after the first surgical procedure, said study first author Angelica Silva-Figueroa, MD, oncological surgeon at RedSalud Avansalud Clinic, Chile, “What is needed is a prognostic staging system for PTC. We do not know which group of patients has an increased risk of relapse.”

The study team, including fellows of American College of Surgeons (ACS; Chicago, IL, USA), examined data on patients treated for PTC between 1980-2016 at the University of Texas MD (UTMD) Anderson Cancer Center (Houston, TX, USA). From a sample size of 68 patient records, 26 patients developed recurrent disease after a median follow up of 4.6 years.

Rather than using the traditional parameter called disease-free survival (DFS), which evaluates effectiveness of a therapy over time, the investigators assessed recurrence-free survival (RFS). After the initial operation to remove the tumor, the RFS rates were 85% at 1 year, 67% at 2 years, and 51% at 10 years.

“The data points used to determine RFS are quantitative and can predict disease recurrence in the first 2-3 years after disease resection,” said senior author Nancy D. Perrier, MD, FACS (fellow of ACS), UTMD Anderson Cancer Center, “This [approach] offers a means to stratify patients and consider more aggressive adjuvant treatment for those at higher risk of recurrence.”

Patients with PTC typically have significantly elevated levels of calcium in their blood as well as other abnormal parathyroid hormone levels. In the multivariate analysis, the team identified 3 adverse characteristics as key prognostic indicators of PTC recurrence: serum calcium level greater than 15 mg/dL, age over 65, and invasion of the tumor into blood vessels.

From there they developed a simple predictive tool by combining these three variables. Patients were stratified into 3 risk groups – low, moderate, and high – based on the number of adverse characteristics each one had, from 0 to 3.

The study found that the 2-year RFS rate after parathyroidectomy was 93% in those with 0 adverse characteristics (low risk), 72% in those with 1 adverse characteristic (moderate risk), and 27% in those with 2 adverse characteristics (high risk). The study also showed that, although the risk of recurrence is greater within 2 years after the initial surgery, this risk continues to increase over the next 10 years and beyond in the moderate risk group.

With this combination of measurable and available information, a patient’s risks can be assessed. For individuals at elevated risk, additional surgery or other adjuvant therapies could be used early on to control cancer recurrence.

“We believe that this scoring system is the first step in personalized cancer care,” Dr. Silva-Figueroa said, “The system may help physicians predict the clinical progression of this disease, reliably aid immediate postoperative treatment decisions, and guide clinical monitoring for progression.” It is currently being validated at 4 centers across the USA. Once these prospective studies have been completed and results are published, the tool can be made available for public use.

This approach “should be employed for other rare tumors where data are insufficient to generate prognostic stages,” said David Winchester, MD, FACS, medical director of Cancer Programs at ACS, “It’s a good model to pave the way for future studies.”

The study, by Silva-Figueroa AM et al, was published April 19, 2017, in the Journal of the American College of Surgeons.

Platinum Member
COVID-19 Rapid Test
OSOM COVID-19 Antigen Rapid Test
One Step HbA1c Measuring System
GREENCARE A1c
Complement 3 (C3) Test
GPP-100 C3 Kit
New
Gold Member
Fully Automated Cell Density/Viability Analyzer
BioProfile FAST CDV

Print article

Channels

Molecular Diagnostics

view channel
Image: The study showed the blood-based cancer screening test detects 83% of people with colorectal cancer with specificity of 90% (Photo courtesy of Guardant Health)

Blood Test Shows 83% Accuracy for Detecting Colorectal Cancer

Colorectal cancer is the second biggest cause of cancer deaths among adults in the U.S., with forecasts suggesting 53,010 people might die from it in 2024. While fewer older adults are dying from this... Read more

Hematology

view channel
Image: The Gazelle Hb Variant Test (Photo courtesy of Hemex Health)

First Affordable and Rapid Test for Beta Thalassemia Demonstrates 99% Diagnostic Accuracy

Hemoglobin disorders rank as some of the most prevalent monogenic diseases globally. Among various hemoglobin disorders, beta thalassemia, a hereditary blood disorder, affects about 1.5% of the world's... Read more

Microbiology

view channel
Image: The new platform is designed to perform blood-based diagnoses of nontuberculosis mycobacteria (Photo courtesy of 123RF)

New Blood Test Cuts Diagnosis Time for Nontuberculous Mycobacteria Infections from Months to Hours

Breathing in nontuberculous mycobacteria (NTM) is a common experience for many people. These bacteria are present in water systems, soil, and dust all over the world and usually don't cause any problems.... Read more

Industry

view channel
Image: These new assays are being developed for use on the recently introduced DxI 9000 Immunoassay Analyzer (Photo courtesy of Beckman Coulter)

Beckman Coulter and Fujirebio Expand Partnership on Neurodegenerative Disease Diagnostics

Beckman Coulter Diagnostics (Brea, CA, USA) and Fujirebio Diagnostics (Tokyo, Japan) have expanded their partnership focused on the development, manufacturing and clinical adoption of neurodegenerative... Read more
Copyright © 2000-2024 Globetech Media. All rights reserved.