ECE2021 Audio Eposter Presentations Calcium and Bone (75 abstracts)
Is necessary long-term follow-up of all patients with primary sporadic hyperparathyroidism undergoing parathyroidectomy?
Ana Castro 1 , Andrea Cruz 1 , Rocío Revuelta 1 , Almudena Vicente 1 , Julia Sastre 1 , Enrique Castro 1 , Manuela Mollejo 2 & Miguel Carrasco 1
1Complejo Hospitalario de Toledo, Endocrinology and Nutrition, Toledo, Spain; 2Complejo Hospitalario de Toledo, Pathology, Toledo, Spain
Introduction
Post parathyroidectomy cure in primary hyperparathyroidism (PHPT) is defined as normocalcemia six months after surgery. The frequency of persistent or recurrent post-surgical disease according to lengthy follow-up studies varies between 1% and 14%.
Objective
To determine if there is a subset of patients with cure criteria 6–12 months after parathyroidectomy that would not require long-term follow-up.
Methods
The medical records of 156 patients with PHPT who underwent initial parathyroidectomy in our hospital between 2005 and 2017, were retrospectively reviewed. Patients with a history of multiple endocrine neoplasia syndrome, and secondary or tertiary hyperparathyroidism were excluded. Cure was defined as a normal level of serum calcium and parathyroid hormone (PTH) 6–12 months after surgery. Disease-free survival was calculated by the Kaplan-Meier method.
Results
The mean age was 56.4 years (± 12.7), with 80.3% being women. Mean follow-up time was 71.2 months (1–180). 141 patients met cure criteria (91.6% cure rate). There was no significant difference in age between cured and not cured (56.7 vs 56.4 years, P = 0.9). Three patients had recurrent disease. The mean time to recurrence was 80 months (range 60–120). Disease-free survival was 90.2% and 88% at 2 and 10 years respectively. 75% of the cured patients had preoperative imaging that was concordant to intraoperative findings and a decrease in intraoperative PTH (IOPTH) > 50%, compared to 50% of the not cured patients (P = 0.17). Disease free survival was 91% at 5 years in patients met these two criteria. The absence of abnormal parathyroid tissue in the histological study was more frequent in not cured patients (25% vs 2.9%) (P < 0.01).
Conclusions
Patients operated on for sporadic PHPT and cured at 6–12 months who present preoperative imaging concordant with surgical findings, a decrease in IOPHT > 50% and abnormal parathyroid tissue in the histological study, probably would not require routine long-term follow-up.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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