Primary hyperparathyroidism due to parathyroid tumors: how the disease has changed — Analysis of results in 335 patients who underwent surgery during the last 20 years.

F. Lumachi, S.M.M. Basso, DF D'Amico, G. Favia

Endocrine Surgery Unit, Department of Surgery & Gastroenterological Sciences, University of Padua, School of Medicine, Via Giustiniani 2, 35128 Padova, Italy tel: +39 049 821 1812, Fax: +39 049 656 145, E-mail:

Background. Primary hyperparathyroidism (HPT) is caused by a single parathyroid (PT) adenomas in more than 85% of cases. The aim of this study was to analyze the results of parathyroidectomy (PTx) in patients who underwent surgery during the last 20 years. Patients and Methods. A series of 335 patients (median age 61 years, range 9-79 years) with proved HPT who underwent successful PTx was reviewed. There were 56 (16.7%) men and 279 (82.3%) women. Patients were divided into two groups: Group A (n=138, 41.2%) who underwent PTx from 1981 to 1989; Group B (n=197, 58.8%) operated on between 1990-2000. All patients un-derwent one or more preoperative localizing studies, such as ultrasonography (US), subtraction scintigraphy (SS) and CT-scan. All patients were followed-up for 12-60 months (median 35). Re-sults. The age of the patients, the PTH levels (A=149.9±108.6, B=186.8±155.2 ng/L), and the greatest diameter of the excised PT tumor (A=20.9±14.5, B=20.1±9.2 mm) measured by the pa-thologist did not differ (p=NS) between the two Groups. The rate of asymptomatic HPT was higher in Group B (25.7% vs 8.6%, p<0.01). US (82.6% vs 83.9%), SS (82.2% vs 84.3%) and CT (77.8% vs 79.2%) sensitivity improved, but the difference was not significant (p=NS). The hospital stay (A=6.4±2.3, B=4.4±1.7 days) was lower (p<0.01) in Group B, and the recovery rate was higher (A=97.8%, B=98.9%; p=NS). Conclusion. In patients with HPT, an earlier diagnosis of the disease and the improved sensitivity of noninvasive localizing procedures may result in shorter hospital stay, lower costs, and similar recovery rate.

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Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Paris, France; February 9 - 12, 2002; in the section on Diagnostic Markers.