Witteveen J, Kievit J, Morreau H, Romijn J, Hamdy N
No recurrence of sporadic primary hyperparathyroidism when cure is established 6 months after parathyroidectomy. [JOURNAL ARTICLE]
Eur J Endocrinol 2009 Nov 2.
Objective: Cure rate for primary hyperparathyroidism is reported to be 94-100% one year after surgery, but recent data suggest recurrence in 4% of patients 1-5 years postoperatively. The aim of our study was to establish the cure rate and its maintenance in the long-term after parathyroidectomy in patients with sporadic primary hyperparathyroidism.
Design: Evaluation of recurrence in patients with sporadic hyperparathyroidism who underwent parathyroidectomy 1-24 years prior to the study. Patients &
Methods: We identified 111 patients who underwent initial PTx between 1984 and 2008 and had no MEN-1, MEN-2 or CaR mutation, parathyroid carcinoma, history of lithium use or renal failure. Thirty-eight patients were lost to follow-up or were unwilling or unable to participate in the study. Cure was defined as maintenance of normal serum calcium and PTH concentrations 6 months after PTx.
Results: Cure was achieved in 68 of 73 patients studied (93%) and was sustained in all for 6+/-5 years.
Conclusion: The cure rate of sporadic primary hyperparathyroidism after initial surgery is 93%. When cure is achieved, this is sustained in 100% of patients for up to 24 years post-operatively. Our data suggest that closer early follow-up is advocated in all patients undergoing PTx to definitively establish cure and to provide a safety net for those with residual gland pathology. The data do not support the need for long term follow-up when cure is established 6 months after PTx.
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