ArticleAnnals of surgical oncology2013
Multigland disease and slower decline in intraoperative PTH characterize mild primary hyperparathyroidism.
Article in Annals of surgical oncology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Intraoperative Parathyroid Hormone Monitoring Criteria in Primary Hyperparathyroidism: A Network Meta-Analysis of Diagnostic Test Accuracy.JAMA otolaryngology-- head & neck surgery · 2025Article
- Primary hyperparathyroidism: predictors of sporadic multi-gland disease.Endocrine connections · 2024Review
- Comparison of Medical Management versus Parathyroidectomy in Patients with Mild Primary Hyperparathyroidism: A Meta-Analysis.Cancers · 2023Review
- Evolving Role of [Journal of clinical medicine · 2023Article
- How low is too low? Intraoperative parathyroid hormone decline in normohormonal primary hyperparathyroidism.Surgery · 2023Article
- Normocalcemic primary hyperparathyroidism.Archives of endocrinology and metabolism · 2022Review
- Article
- The Significance of Histologically "Large Normal" Parathyroid Glands in Primary Hyperparathyroidism.World journal of surgery · 2020Article
- Predictors of multiglandular disease in primary hyperparathyroidism.Langenbeck's archives of surgery · 2018Article
- Improving diagnostic recognition of primary hyperparathyroidism with machine learning.Surgery · 2017Article
- "Silent" kidney stones in "asymptomatic" primary hyperparathyroidism-a comparison of multidetector computed tomography and ultrasound.Langenbeck's archives of surgery · 2017Article
- Use of the gamma probe to identify multigland disease in primary hyperparathyroidism.International journal of endocrine oncology · 2016Article
- Sporadic multiple parathyroid gland disease--a consensus report of the European Society of Endocrine Surgeons (ESES).Langenbeck's archives of surgery · 2015Review
- Italian Society of Endocrinology Consensus Statement: definition, evaluation and management of patients with mild primary hyperparathyroidism.Journal of endocrinological investigation · 2015Article
- CaPTHUS scoring model in primary hyperparathyroidism: can it eliminate the need for ioPTH testing?Annals of surgical oncology · 2015Article
- Mild primary hyperparathyroidism: a literature review.The oncologist · 2014Review
- MULTIGLANDULAR PARATHYROID GLAND DISEASE: AN INCIDENTAL DISCOVERY IN NORMOCALCEMIC PATIENTS DURING THYROID SURGERY.Acta endocrinologica (Bucharest, Romania : 2005)Article
- PRIMARY HYPERPARATHYROIDISM - STRATEGY FOR MULTIGLAND DISEASE IN THE ERA OF SPECT-CT.Acta endocrinologica (Bucharest, Romania : 2005)Article
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7 authors.
Funding
Abstract
backgroundMany patients with primary hyperparathyroidism (PHPT) present with less severe biochemical parameters. The purpose of this study was to compare the presentation, operative findings, and outcomes of these patients with "mild" PHPT to patients with "overt" disease.
methodsA retrospective review of a prospectively collected parathyroid database was performed to identify cases of PHPT undergoing an initial neck operation. Patients were classified as mild when either the preoperative calcium or PTH was within the normal limits. Comparisons were made with the Student's t test, Chi-squared test, or Wilcoxon rank-sum test where appropriate. Kaplan-Meier estimates were plotted for disease-free survival and compared by the log-rank test.
resultsOf the 1,429 patients who met inclusion criteria, 1,049 were classified as overt and 388 (27.1 %) were mild. Within the mild group, 122 (31.4 %) presented with normocalcemic PHPT and 266 (68.6 %) had a normal PTH. The two groups had similar demographics and renal function. Interestingly, the mild group had more than double the rate of kidney stones (3.1 vs. 1.3 %, p = 0.02). The mild group was less likely to localize on sestamibi scan (62.4 vs. 78.7 %, p < 0.01). Intraoperatively, more mild patients exhibited multigland disease (34.3 vs. 14.1 %, p < 0.01). When examining intraoperative PTH (IoPTH) kinetics where single adenomas were excised, the IoPTH fell at a rate of 6.9 pg/min in mild patients compared with 11.5 pg/min in the overt group (p < 0.01). Accordingly, 62.2 % of patients in the overt group and 53.3 % in the mild group were cured at 5 min postexcision (p < 0.01). There was no difference in the rates of persistence or recurrence between the groups, and disease-free survival estimates were identical (p = 0.27).
conclusionsPatients with mild PHPT were more likely to have multigland disease and a slower decline in IoPTH, but these patients can be successfully treated with surgery.
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