Parathyroid Carcinoma: Incidence, Survival Analysis, and Management: A Study from the SEER Database and Insights into Future Therapeutic Perspectives

Asad Ullah, Jaffar Khan, Abdul Waheed, Nitasha Sharma, Elizabeth K. Pryor, Tanner R. Stumpe, Luis Velasquez Zarate, Frederick D. Cason, Suresh Kumar, Subhasis Misra, Sravan Kavuri, Hector Mesa, Nitin Roper, Shahin Foroutan, Nabin Raj Karki, Jaydira Del Rivero, William F. Simonds, Nagla Abdel Karim

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Introduction: Parathyroid carcinoma (PC) is an extremely rare entity, with a frequency of 0.005% of all malignancies. Most data related to this rare disease are limited to case series and a few database studies. We present a large database study that aims to investigate the demographic, clinical, and pathological factors, prognosis, and survival of PC. Methods: Data of parathyroid carcinoma were extracted from the Surveillance, Epidemiology, and End Results (SEER) diagnosed between 1975 and 2016. Results: PC had a slightly higher incidence in men (52.2%, p < 0.005), the majority of cases affected Caucasians (75.4%, p < 0.005), and the mean age at diagnosis was 62 years. Histologically, 99.7% were adenocarcinomas not otherwise specified (p < 0.005), well-differentiated (p < 0.005), and 2–4 cm (p < 0.001) in size among the patients with available data. In cases with staging provided, most PC were organ-confined (36.8%, p < 0.001). Lymph nodes were positive in 25.2% of cases where lymph node status was reported. The main treatment modality was surgery (97.2%), followed by radiation alone (2%), and very few received chemotherapy alone (0.8%), p < 0.005. Five-year follow-up was available for 82.7% of the cases. Those who underwent surgery only or radiation alone had 5-year survivals of 83.8% and 72.2%, respectively (p < 0.037). Multivariable analysis identified tumor size >4 cm, age > 40 years, male sex, Caucasian race, distant spread, and poorly differentiated grade as independent risk factors for mortality (p < 0.001). Conclusion: PC is a very rare tumor mostly affecting Caucasian individuals in the fifth decade. Older age, poor histologic differentiation, and distant metastasis are associated with a worse prognosis. Surgical resection offers the best survival outcome. To better understand the pathogenesis and factors affecting survival, all PC patients should be enrolled in national and international registries.

Original languageEnglish (US)
Article number1426
Issue number6
StatePublished - Mar 1 2022


  • Cancer staging
  • Incidence
  • Mortality
  • Parathyroid carcinoma
  • SEER program
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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