Patient selection: parathyroid carcinoma
High risk group - any of the following (Stage II, III, or IV):
(1) vascular invasion
(2) lymph node metastases
(3) distant metastases (lung, mediastinum, bone, etc)
(4) invasion into a vital organ (hypopharynx, trachea, esophagus, recurrent laryngeal nerve, carotid artery)
Low risk group (Stage I):
(1) capsular invasion (T1)
(2) invasion of surrounding soft tissue excluding vital structures (T2)
Risk of recurrence and death are associated with understaging and undertreatment.
