BACKGROUND: Whether total parathyroidectomy (TPTX) or subtotal parathyroidectomy (SPTX) should be performed for primary hyperparathyroidism (PHPT) in patients with multiple endocrine neoplasia type 1 (MEN1) is controversial. At our institution, the parathyroidectomy strategy is based on the number of enlarged intraoperative parathyroid glands. We retrospectively analyzed our parathyroidectomy procedures. METHODS: Data of PHPT treatment in patients with MEN1 who underwent parathyroidectomy from 1982 to 2012 at our department were retrospectively collected. The data were grouped according to the surgical procedure: TPTX, SPTX, and less than SPTX (LPTX). TPTX or SPTX was selected based on the preoperative examination findings and number of enlarged intraoperative parathyroid glands. The outcomes were the disease-free survival (DFS) rate and postoperative calcium replacement rate based on Kaplan-Meier analysis for each type of surgical procedure. RESULTS: Forty-five patients were analyzed. The overall 5- and 10-year DFS was 91.7 and 55.8%, respectively. The 5- and 10-year DFS in each subgroup was 100.0 and 85.7% in the TPTX group, 89.4 and 57.3% in the SPTX group, and 91.6 and 57.3% in the LPTX group, respectively. The postoperative calcium replacement rate at 1 and 12 months was 91.7 and 58.3% in the TPTX group, 21.1 and 7.0% in the SPTX group, and 30.0 and 0.0% in the LPTX group, respectively. CONCLUSIONS: Although LPTX was not satisfactory as a standard procedure, both SPTX and TPTX are effective treatment methods for PHPT in patients with MEN1. The parathyroidectomy strategy should be based on intraoperative evaluation of the parathyroid glands.
BACKGROUND: Whether total parathyroidectomy (TPTX) or subtotal parathyroidectomy (SPTX) should be performed for primary hyperparathyroidism (PHPT) in patients with multiple endocrine neoplasia type 1 (MEN1) is controversial. At our institution, the parathyroidectomy strategy is based on the number of enlarged intraoperative parathyroid glands. We retrospectively analyzed our parathyroidectomy procedures. METHODS: Data of PHPT treatment in patients with MEN1 who underwent parathyroidectomy from 1982 to 2012 at our department were retrospectively collected. The data were grouped according to the surgical procedure: TPTX, SPTX, and less than SPTX (LPTX). TPTX or SPTX was selected based on the preoperative examination findings and number of enlarged intraoperative parathyroid glands. The outcomes were the disease-free survival (DFS) rate and postoperative calcium replacement rate based on Kaplan-Meier analysis for each type of surgical procedure. RESULTS: Forty-five patients were analyzed. The overall 5- and 10-year DFS was 91.7 and 55.8%, respectively. The 5- and 10-year DFS in each subgroup was 100.0 and 85.7% in the TPTX group, 89.4 and 57.3% in the SPTX group, and 91.6 and 57.3% in the LPTX group, respectively. The postoperative calcium replacement rate at 1 and 12 months was 91.7 and 58.3% in the TPTX group, 21.1 and 7.0% in the SPTX group, and 30.0 and 0.0% in the LPTX group, respectively. CONCLUSIONS: Although LPTX was not satisfactory as a standard procedure, both SPTX and TPTX are effective treatment methods for PHPT in patients with MEN1. The parathyroidectomy strategy should be based on intraoperative evaluation of the parathyroid glands.
Authors: Mark Versnick; Aleksandra Popadich; Stan Sidhu; Mark Sywak; Bruce Robinson; Leigh Delbridge Journal: Surgery Date: 2013-07 Impact factor: 3.982
Authors: Maria D Balsalobre Salmeron; Jose Manuel Rodriguez Gonzalez; Joan Sancho Insenser; Joan Sancho Fornos; Albert Goday; Nuria Maria Torregrosa Perez; Antonio Rios Zambudio; Pascual Parrilla Paricio; Antonio Sitges Serra Journal: World J Surg Date: 2010-06 Impact factor: 3.352
Authors: M L Brandi; R F Gagel; A Angeli; J P Bilezikian; P Beck-Peccoz; C Bordi; B Conte-Devolx; A Falchetti; R G Gheri; A Libroia; C J Lips; G Lombardi; M Mannelli; F Pacini; B A Ponder; F Raue; B Skogseid; G Tamburrano; R V Thakker; N W Thompson; P Tomassetti; F Tonelli; S A Wells; S J Marx Journal: J Clin Endocrinol Metab Date: 2001-12 Impact factor: 5.958
Authors: Laura A Lambert; Suzanne E Shapiro; Jeffrey E Lee; Nancy D Perrier; Mylene Truong; Michael J Wallace; Ana O Hoff; Robert F Gagel; Douglas B Evans Journal: Arch Surg Date: 2005-04
Authors: Dina M Elaraj; Monica C Skarulis; Steven K Libutti; Jeffrey A Norton; David L Bartlett; James F Pingpank; Fathia Gibril; Lee S Weinstein; Robert T Jensen; Stephen J Marx; H Richard Alexander Journal: Surgery Date: 2003-12 Impact factor: 3.982
Authors: Anathea C Powell; H Richard Alexander; James F Pingpank; Seth M Steinberg; Monica Skarulis; David L Bartlett; Sunita Agarwal; Craig Cochran; Geoffrey Seidel; Douglas Fraker; Marybeth S Hughes; Robert T Jensen; Stephen J Marx; Steven K Libutti Journal: Surgery Date: 2008-12 Impact factor: 3.982
Authors: Francesco Tonelli; Tommaso Marcucci; Geri Fratini; Maria Silvia Tommasi; Alberto Falchetti; Maria Luisa Brandi Journal: Ann Surg Date: 2007-12 Impact factor: 12.969
Authors: Naris Nilubol; Lee S Weinstein; William F Simonds; Robert T Jensen; Stephen J Marx; Electron Kebebew Journal: Ann Surg Oncol Date: 2015-11-05 Impact factor: 5.344