SynthesisJournal of endocrinological investigation2021
Efficacy of parathyroidectomy compared with active surveillance in patients with mild asymptomatic primary hyperparathyroidism: a systematic review and meta-analysis of randomized-controlled studies.
Synthesis in Journal of endocrinological investigation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Italian Guidelines for the Management of Sporadic Primary Hyperparathyroidism.Endocrine, metabolic & immune disorders drug targets · 2024Guideline
- Parathyroidectomy for adults with primary hyperparathyroidism.The Cochrane database of systematic reviews · 2023Pooled it
- Comparison of the two treatment methods in primary hyperparathyroidism due to solitary parathyroid adenoma, Ultrasound-guided percutaneous alcohol ablation vs. parathyroidectomy: a randomized controlled trial.BMC endocrine disorders · 2025Trial
- Preoperative Zoledronate Use and Risk of Postoperative Hypocalcemia After Parathyroidectomy for Primary Hyperparathyroidism: A Comparative Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Article
- Philippine Clinical Practice Guidelines for Periodic Health Examination: Screening for Renal, Metabolic, Nutritional, and Endocrine Disorders.Acta medica Philippina · 2026Article
- Kidney stone recurrence in hypercalcemic and normocalcemic primary hyperparathyroidism without parathyroidectomy.Endocrine connections · 2025Article
- Bone Disease in Primary Hyperparathyroidism.Journal of musculoskeletal & neuronal interactions · 2025Review
- Comparative analysis of surgical versus medical treatment in non-localized primary hyperparathyroidism: renal and skeletal outcomes.Updates in surgery · 2025Article
- Bone Mineral Density and First Line Imaging with [Diagnostics (Basel, Switzerland) · 2024Article
- Article
- Neuroendocrine Parathyroid Tumors: Quality of Life in Patients with Primary Hyperparathyroidism.Biomedicines · 2023Review
- Bone quality in endocrine diseases: determinants and clinical relevance.Journal of endocrinological investigation · 2023Review
- Comparison of Medical Management versus Parathyroidectomy in Patients with Mild Primary Hyperparathyroidism: A Meta-Analysis.Cancers · 2023Review
- Limited disease progression in endocrine surgery patients with treatment delays due to COVID-19.Surgery · 2023Article
- Analysis of Comorbidities, Clinical Outcomes, and Parathyroidectomy in Adults With Primary Hyperparathyroidism.JAMA network open · 2022Article
- Secondary Osteoporosis and Metabolic Bone Diseases.Journal of clinical medicine · 2022Review
- The impact of age on quality of life and frailty outcomes after parathyroidectomy in patients with primary hyperparathyroidism.Journal of endocrinological investigation · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveParathyroidectomy (PTx) has an established benefit in patients with symptomatic primary hyperparathyroidism (PHPT). However, its efficacy in mild asymptomatic PHPT has not been proven. This study aimed to systematically review and meta-analyze the best available evidence from randomized-controlled trials comparing the efficacy of PTx over conservative management (non-PTx) on skeletal outcomes [fractures and bone mineral density (BMD)], nephrolithiasis risk and quality of life (QoL) in patients with mild asymptomatic PHPT.
methodsA comprehensive literature search was conducted in PubMed, Scopus and Cochrane databases, from conception to February 23, 2020. Data were extracted from the studies that fulfilled the eligibility criteria and were synthesized quantitatively (fixed or random effects model) as relative risks and percentage mean differences (MD) with 95% confidence intervals (CI). I
resultsFour studies were included in the meta-analysis. There was no difference in fracture risk between PTx and active surveillance. The PTx group demonstrated higher BMD [MD 3.55% (95% CI 1.81, 5.29) in lumbar spine and 3.44% (95% CI 1.39, 5.49) in total hip, without difference in femoral neck and forearm] and lower calcium concentrations (MD - 13.26%, 95% CI - 7.10, - 19.43) compared with the non-PTx group. No difference was observed between groups regarding nephrolithiasis or QoL indices, except for general health (higher in PTx group).
conclusionsIn patients with mild asymptomatic PHPT, PTx increases BMD and reduces serum calcium concentrations. However, its superiority over active surveillance in terms of fracture risk, nephrolithiasis and QoL cannot be supported by current data.
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Registered trials
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