ISPO

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: flumachi@unipd.it

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.

For more information, contact flumachi@unipd.it

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

http://www.cancerprev.org/Journal/Issues/26/101/1291/4548