Neoplasms

All Conditions

Gland and Hormone Related Diseases

Rare Diseases

Carcinoma

Hyperparathyroidism

Hyperparathyroidism, Primary

Parathyroid Neoplasms

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Endocrine Gland Neoplasms

Head and Neck Neoplasms

Endocrine System Diseases

Parathyroid Diseases

Primary Hyperparathyroidism

Parathyroid Carcinoma

All Drugs and Chemicals

Bone Density Conservation Agents

Parathyroid Hormone

Hormones

Calcium

Calcium, Dietary

All adult (18 years old and older) patients registered in EUROCRINE® database that underwent surgery for primary hyperparathyroidism and received histopathologic diagnosis of parathyroid carcinoma from 2015 till 2021 will be included

Radical treatment of suspected parathyroid carcinoma should consist of parathyroidectomy and en bloc ipsilateral hemithyroidectomy and central lymph node dissection.

Surgical treatment of parathyroid carcinoma

Francesco Pennestrì, Dr

Marco Raffaelli, Prof

The main aim of the study is to evaluate the incidence of post-operative diagnosis of PC and atypical parathyroid neoplasm in patients who underwent surgery for pHPT in different European centers using the EUROCRINE® database. Moreover, we aim to evaluate the peri-operative surgical characteristics, operation extent, postoperative morbidity, and outcomes in these patients category.

Parathyroid cancer (PC) is one of the rarest malignancies (0.005% of all tumours) and it represents less than 1% of all the causes of primary hyperparathyroidism (pHPT).

It is frequently a sporadic disease, but it can be part of hereditary syndromes (i.e. HPT- JT, MEN, MEN2A and FIHP).

Clinical and biochemical presentation is usually more severe comparing to other forms of primary hyperparathyroidism as it is often associated to very high serum-calcium and PTH levels and target organs' damages.

Malignancy should be suspected on the basis of the aforementioned biochemical data and the imaging evidences (such as parathyroid lesion dimension \>3 cm, faded edges, inhomogeneous internal features and cervical lymph nodes enlargement).

In case of suspected PC a radical treatment should be proposed to the patient, consisting of parathyroidectomy and en bloc ipsilateral hemithyroidectomy and ipsilateral central neck dissection. Indeed, the oncological radicality during surgical treatment is mandatory, as effective adjuvant therapy is not available.

However, pre-operative differential diagnosis with parathyroid adenoma is still challenging, thus malignancy can be detected only after the histological analysis of the specimen and sometimes after recurrences.

Moreover, parathyroid atypical adenoma entity is still controversial, as it presents suspicious histological features, but certain signs of malignancy are lacking (such as capsular, vessels and neural invasion). Furthermore, natural history and biological behaviour are still unknown.

European Multicentric Study on Parathyroid Carcinoma

Reasonable requests will be evaluated by the Eurocrine Council

Descriptive analysis of the exact incidence of parathyroid carcinoma among patients undergoing surgical treatment of primary hyperparathyroidism in European centers.

Descriptive analysis of operative and oncologic outcome of patients undergoing surgical treatment of primary hyperparathyroidism and receiving pathological report od parathyroid carcinoma in European centers.

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Adrenocortical Carcinoma

Adenocarcinoma

Adrenal Cortex Neoplasms

Adrenal Gland Neoplasms

Adrenal Cortex Diseases

Adrenal Gland Diseases

Vasoconstrictor Agents

Respiratory System Agents

Epinephrine

Racepinephrine

Epinephryl borate

All adult (18 years old and older) patients registered in EUROCRINE® database that underwent surgery for adrenocortical carcinoma from 2015 till 2021 will be included

Regarding lymphadenectomy extent, it will be described as locoregional or systematic depending on availability of data in the Eurocrine database.

Adrenalectomy with or without lymphadenectomy

Francesco Pennestri, Dr

This project will evaluate of the number of patients who underwent adrenalectomy for ACC in different European centers using the EUROCRINE® database. The analysis will focus on the extent of lymph nodal dissection (i.e. number of lymph nodes and nodal stations dissected during adrenalectomy). We aim to evaluate the oncologic radicality of surgical treatment and the rate of tumour recurrences after surgery and nodal metastasis related to the stage of the disease and to tumour side (left/right).

Adrenocortical carcinoma (ACC) is a rare malignancy with an estimated annual incidence of only 0.5 to 2.0 per million population and a high rate of mortality: Stage I, II and III 5 years-survival is respectively 84%, 63% and 24%, while medium survival is less than 12 months for metastatic disease. Stage of the disease, age at diagnosis, tumour grading and complete surgical resection are the main prognostic factors. Surgical treatment is the only effective therapeutic strategy for ACC and recent guidelines recommend loco-regional lymph node dissection as a fundamental surgical element in order to guarantee complete resection. However, adrenal lymphatic drainage can be variable. The main collecting lymph nodes representing the first tiers in the lymphatic drainage are the peri-adrenal nodes and the renal ilum nodes. In addition, the posterior lymphatic drainage flows to lymph nodes located posterior to the IVC, and on the right edge of the aorta for the right adrenal gland, or on its right left edge for the left gland, stretching from the celiac region near the diaphragmatic crus to the renal vessels.

The anterior lymphatic drainage flows downward to the lumboaortic nodes and ends in the interaortocaval space, on the right edge of the aorta for the right adrenal gland, and on its right left edge for the left gland and mainly around the renal hilum. Collecting nodes can be located below the renal pedicle, sometimes extending as far as the origin of the iliac vessel. Most authors concur in describing a lymphatic drainage that passes through the diaphragm directly into the posterior mediastinal nodes. A majority of lymphatic channels run medially to the thoracic duct, often without the involvement of any lymph nodes. Furthermore, it is impossible to predict which pathway would be involved in case of a malignant lesion, because all pathways would probably be involved simultaneously because of the size, often \>10 cm, of ACC at diagnosis, and considering that the lymphatic stream can be disorganized because of the tumour volume or lymph node involvement. Therefore, the extent of lymph node dissection in order to involve other stations should be considered only on the basis of pre-operative radiological evidence and intra-operative evaluation. Despite aggressive surgical resection, local and distant recurrence rate after R0 surgery remains as high as 50-80%, potentially because of the lack of an accurate identification of the nodes stations for the lymph node dissection. Indeed, nodes drain disorganization due to the high tumour volume makes impossible to predict accurately the lymphatic metastatic pathway. In this context, the rarity of ACC leads to heterogeneity of the scientific studies and consequently to the lack of perspective works, so that tumour recurrence evaluation refers to patients categories who underwent lymph node dissection with or without preoperative evidence of nodal disease

European Multicenter Study on Role of Lymph Node Dissection in Surgical Management of Adrenal Cortical Carcinoma

Identification of the number of patients who underwent adrenalectomy for diagnosis of ACC among European centers participating in the Eurocrine database

Evaluation of the lymph node dissection extension (in terms of number of lymph nodes and nodal stations dissected during surgical treatment for ACC)

Descriptive analysis of oncologic outcome (in terms of disease recurrence, lymph node metastasis and their association to the tumour stage) in patients who underwent surgical treatment of ACC in European centers

Thyroid Neoplasms

Thyroid Diseases

Thyroid Cancer, Papillary

Thyroid Carcinoma, Anaplastic

Carcinoma, Medullary

Carcinoma, Neuroendocrine

Neuroendocrine Tumors

Neuroectodermal Tumors

Neuroectodermal Tumors, Primitive

Neoplasms, Germ Cell and Embryonal

Neoplasms, Nerve Tissue

Adenocarcinoma, Papillary

Anaplastic Thyroid Cancer

Thyroid Cancer, Medullary

Thyroid Cancer, Follicular

Neuroendocrine Tumor

Neuroepithelioma

All adult (18 years old and older) patients registered in EUROCRINE® database with stage IV thyroid cancer, M1, N1b, or T3b and above will be included

Lymph node dissection, as well as its surgical extension, was performed according to the surgeon's discretion. Multivisceral operations involved oesophagus, trachea and larynx.

Thyroidectomy with or without lymphadenectomy or multivisceral resection

Luca Sessa, Dr

The main aim of the study is to evaluate peri-operative surgical characteristics, operation extent, postoperative morbidity, and outcomes in patients undergoing surgery for advanced thyroid cancer in different European centers using the EUROCRINE® database.

The incidence of thyroid cancer has risen exponentially over the last decades among developed countries. Even though this is mainly attributed to small well differentiated carcinomas (DTC) with excellent prognosis, the rates of advanced disease have also elevated. While the characteristics of advanced thyroid cancer are intuitively recognized by experienced surgeons of the field, a common definition among scientific societies is yet to be reached. The four main features of advanced cancer are locally and regionally advanced disease, distant metastasis, and recurrence. Guidelines for the optimal treatment of advanced disease are mainly included in the broader guidelines of each cancer subtype, such as the American Thyroid Association (ATA) guidelines for DTC, Medullary Thyroid Carcinoma (MTC) and most recently Anaplastic Thyroid Carcinoma (ATC). In the European setting, the European Society for Medical Oncology (ESMO) 2019 guidelines on thyroid cancer include a subsection for the management of advanced disease of each thyroid cancer type. A common limitation among published guidelines is the moderate to low level of evidence upon which the advanced disease recommendations are based; however, broad consensus has been reached regarding the paramount importance of surgery if an R0/R1 resection is achievable. Recently, new advances in targeted therapy guided by genetic alterations found in the tumor have provided new treatment options for patients; therefore, latest guidelines encourage the inclusion of patients with advanced disease in these clinical trials. Finally, neoadjuvant therapy modalities are constantly gaining ground with promising results allowing a greater portion of patients to benefit from surgery.

European Multicenter Study on Surgical Management of Advanced Thyroid Cancer

European Multicenter Study on Perioperative Management, Operative Strategy, Morbidity, and Outcomes of the Surgical Management of Advanced Thyroid Cancer: (EUROCRINE® Study Group).

Descriptive analysis of overall survival, recurrence and mortality in patients undergoing surgery for advanced thyroid cancer in European centers.

Descriptive analysis of surgical perioperative characteristics of patients undergoing surgery for advanced thyroid cancer in European centers.

Descriptive analysis of short-term clinical outcomes of patients undergoing surgery for advanced thyroid cancer in European centers in terms of RLN palsy, critical neurovascular injury and voice changes through otorhinolaryngologist and clinical post-operative evaluation

Descriptive analysis of short-term clinical outcomes of patients undergoing surgery for advanced thyroid cancer in European centers in terms of surgical complications, such as bleeding, lymphorrea tracheal or oesophageal injury (detected through clinical and/or imaging evaluation).

Descriptive analysis of short-term clinical outcomes of patients undergoing surgery for advanced thyroid cancer in European centers in terms of hypocalcemia, hypoparathormonemia (detected through clinical and/or laburatoristic evaluation).

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
European Multicentric Study on Parathyroid Carcinoma	NCT05789680	Parathyroid Car...	Surgical treatm...	18 Years -	Fondazione Policlinico Universitario Agostino Gemelli IRCCS
European Multicenter Study on Role of Lymph Node Dissection in Surgical Management of Adrenal Cortical Carcinoma	NCT05763524	Adrenocortical ...	Adrenalectomy w...	18 Years -	Fondazione Policlinico Universitario Agostino Gemelli IRCCS
European Multicentric Study on Parathyroid Carcinoma	NCT05789680	Parathyroid Car...	Surgical treatm...	18 Years -	Fondazione Policlinico Universitario Agostino Gemelli IRCCS
European Multicenter Study on Surgical Management of Advanced Thyroid Cancer	NCT05796960	Thyroid Carcino... Thyroid Cancer Thyroid Neoplas... Thyroid Cancer,... Thyroid Cancer,... Thyroid Medulla... Anaplastic Thyr...	Thyroidectomy w...	18 Years -	Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Spots Global Cancer Trial Database for eurocrine

Every month we try and update this database with for eurocrine cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Spots Global Cancer Trial Database for eurocrine

Every month we try and update this database with for eurocrine cancer trials from around the world to help patients and their families find trials that might be right for them. We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Every month we try and update this database with for eurocrine cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.