Researchers described the clinical presentation and workup of parathyroid cancer (PC) and estimated clinical prognostic factors in the retrospective cohort analysis. Recurrence-free survival was the primary endpoint. Between 1986 and 2018, 83 people were diagnosed with PC. The Kaplan-Meier method was used to calculate disease-specific and recurrence-free survivals. Binary logistic regression with age and sex adjustments was used to identify risk factors for recurrence. A total of 39 tumors were examined by a central histopathologist. Symptoms of renal disease (39.8%), gastrointestinal disease (24.1%), bone disease (22.9%), and psychiatric disease (19.3%) were the most common. The surgical treatment was varied [parathyroidectomy (PTx) alone was 22.9%, PTx with hemithyroidectomy was 24.1%, en bloc resection was 15.7%, and others were 37.3%]. Serious surgical complications were common (recurrent laryngeal nerve palsy 25.3%; hypoparathyroidism 6%). PC recurred in 32 of the 83 instances studied. In univariate analysis, the longer initial surgery was associated with a lower recurrence rate (P=0.04). Low T status [odds ratio (OR) = 2.65, 95% CI 1.02–6.88, P=0.045], N0 stage at initial diagnosis (OR = 6.32, 95% CI 1.33–30.01, P=0.02), Ki-67 less than 10% (OR = 14.07, 95% CI 2.09–94.9, P=0.007), and postoperative biochemical remission (OR = 0.023, 95% CI 0.001–0.52, P=0.018) were beneficial prognostic parameters for recurrence-free survival. Despite a good overall prognosis, PC had a high probability of recurrence, which necessitates additional surgery and results in recurrent laryngeal nerve palsy and hypoparathyroidism. When PC was confirmed, ipsilateral completion surgery may be considered due to the lower recurrence rate in cases of extended operation.
