ArticleUpdates in surgery2026
PTH-to-tumor-volume ratio as a potential exploratory marker in parathyroid carcinoma: a retrospective cohort study.
Article in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundParathyroid carcinoma is a rare endocrine malignancy that remains difficult to distinguish preoperatively from benign causes of primary hyperparathyroidism due to overlapping clinical and biochemical features. This study evaluates the serum parathyroid hormone (PTH)-to-tumor volume ratio as a potential parameter for differentiating parathyroid carcinoma from benign parathyroid lesions.
methodsA retrospective analysis was conducted on 344 patients who underwent surgery for primary hyperparathyroidism between 2017 and 2024. Patients were divided into carcinoma (n = 8) and benign lesion groups (n = 336). Clinical, biochemical, and ultrasound-derived tumor volume data were analyzed and compared between groups.
resultsPatients with parathyroid carcinoma had significantly higher PTH levels than those with benign lesions (median, 659 vs. 136.4 pg/mL; p = 0.002) and markedly larger tumor volumes (median, 10.14 vs. 0.69 ml; p < 0.001). Despite higher absolute PTH concentrations, the PTH-to-tumor volume ratio was significantly lower in the carcinoma group (median 89.7 vs. 214.56; p = 0.011). In logistic regression analysis, a lower PTH-to-tumor volume ratio was associated with an increased likelihood of parathyroid carcinoma (OR, 0.990; 95% CI: 0.896-0.993; p = 0.04).
conclusionsIn this cohort, parathyroid carcinoma was characterized by a substantially greater tumor burden and higher circulating PTH concentrations, while the PTH-to-tumor-volume ratio was lower than in benign parathyroid lesions. The observed difference in the ratio is hypothesis-generating and warrants confirmation in larger, multicenter studies. Given the limited number of carcinoma cases, its role in clinical decision-making remains to be established.
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