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Article: Eucalcemic parathyroid hormone elevation after parathyroidectomy for primary sporadic hyperparathyroidism: risk factors, trend, and outcome

TitleEucalcemic parathyroid hormone elevation after parathyroidectomy for primary sporadic hyperparathyroidism: risk factors, trend, and outcome
Authors
KeywordsCalcium blood level
Hyperparathyroidism
Parathyroid hormone blood level
Parathyroidectomy
Postoperative period
Issue Date2012
PublisherSpringer New York LLC. The Journal's web site is located at http://www.annalssurgicaloncology.org
Citation
Annals of Surgical Oncology, 2012, v. 19 n. 2, p. 584-590 How to Cite?
AbstractBACKGROUND: Patients with eucalcemic parathyroid hormone elevation (ePTH) after parathyroidectomy for primary hyperparathyroidism (HPT) may be at risk of recurrence. We aimed to examine risk factors, trend of PTH level, and outcome of patients with ePTH 6 months after parathyroidectomy. METHODS: A total of 161 primary HPT were analyzed. The 6-month postoperative calcium and PTH levels were obtained. ePTH was defined as an elevated PTH level in the presence of normocalcemia. At 6 months, 98 had eucalcemic normal PTH and 63 (39.1%) had ePTH. Perioperative variables, PTH trend, and outcome were compared between 2 groups. Multivariable analyses were performed to identify independent preoperative and operative/postoperative risk factors for ePTH. RESULTS: Among preoperative factors, advanced age (odds ratio [OR] = 1.042, P = .027) and low 25-hydroxyvitamin D(3) (25OHD(3)) (OR = 1.043, P = .009) were independently associated with ePTH, whereas among operative/postoperative factors, high 10-min intraoperative PTH level (OR = 1.015, P = .040) and high postoperative 3-month PTH (OR = 1.048, P < .001) were independently associated with ePTH. After a mean follow-up of 38.7 months, recurrence rate was similar between the 2 groups (P = 1.00). In the first 2 postoperative years, 75 (46.6%) had ePTH on at least 1 occasion and 8 (5.0%) had persistently ePTH on every occasion. CONCLUSIONS: Advanced age, low 25OHD(3), high 10-min intraoperative PTH, and high postoperative 3-month PTH were independently associated with ePTH at 6-month. Although 39.1% of patients had ePTH at 6 months, more than 50% had at least 1 ePTH within the first 2 years of follow-up. Recurrence appeared similar between those with or without ePTH at 6 months.
Persistent Identifierhttp://hdl.handle.net/10722/144927
ISSN
2015 Impact Factor: 3.655
2015 SCImago Journal Rankings: 1.902
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLang, BHHen_US
dc.contributor.authorWong, IYHen_US
dc.contributor.authorWong, KPen_US
dc.contributor.authorLo, CYen_US
dc.date.accessioned2012-02-21T05:43:00Z-
dc.date.available2012-02-21T05:43:00Z-
dc.date.issued2012en_US
dc.identifier.citationAnnals of Surgical Oncology, 2012, v. 19 n. 2, p. 584-590en_US
dc.identifier.issn1068-9265en_US
dc.identifier.urihttp://hdl.handle.net/10722/144927-
dc.description.abstractBACKGROUND: Patients with eucalcemic parathyroid hormone elevation (ePTH) after parathyroidectomy for primary hyperparathyroidism (HPT) may be at risk of recurrence. We aimed to examine risk factors, trend of PTH level, and outcome of patients with ePTH 6 months after parathyroidectomy. METHODS: A total of 161 primary HPT were analyzed. The 6-month postoperative calcium and PTH levels were obtained. ePTH was defined as an elevated PTH level in the presence of normocalcemia. At 6 months, 98 had eucalcemic normal PTH and 63 (39.1%) had ePTH. Perioperative variables, PTH trend, and outcome were compared between 2 groups. Multivariable analyses were performed to identify independent preoperative and operative/postoperative risk factors for ePTH. RESULTS: Among preoperative factors, advanced age (odds ratio [OR] = 1.042, P = .027) and low 25-hydroxyvitamin D(3) (25OHD(3)) (OR = 1.043, P = .009) were independently associated with ePTH, whereas among operative/postoperative factors, high 10-min intraoperative PTH level (OR = 1.015, P = .040) and high postoperative 3-month PTH (OR = 1.048, P < .001) were independently associated with ePTH. After a mean follow-up of 38.7 months, recurrence rate was similar between the 2 groups (P = 1.00). In the first 2 postoperative years, 75 (46.6%) had ePTH on at least 1 occasion and 8 (5.0%) had persistently ePTH on every occasion. CONCLUSIONS: Advanced age, low 25OHD(3), high 10-min intraoperative PTH, and high postoperative 3-month PTH were independently associated with ePTH at 6-month. Although 39.1% of patients had ePTH at 6 months, more than 50% had at least 1 ePTH within the first 2 years of follow-up. Recurrence appeared similar between those with or without ePTH at 6 months.en_US
dc.languageengen_US
dc.publisherSpringer New York LLC. The Journal's web site is located at http://www.annalssurgicaloncology.orgen_US
dc.relation.ispartofAnnals of Surgical Oncologyen_US
dc.rightsCreative Commons: Attribution 3.0 Hong Kong Licenseen_US
dc.rightsThe original publication is available at www.springerlink.comen_US
dc.subjectCalcium blood levelen_US
dc.subjectHyperparathyroidismen_US
dc.subjectParathyroid hormone blood levelen_US
dc.subjectParathyroidectomyen_US
dc.subjectPostoperative period-
dc.titleEucalcemic parathyroid hormone elevation after parathyroidectomy for primary sporadic hyperparathyroidism: risk factors, trend, and outcomeen_US
dc.typeArticleen_US
dc.identifier.emailLang, BHH: blang@hkucc.hku.hk-
dc.identifier.emailLo, CY: cylo@hkucc.hku.hk-
dc.description.naturepublished_or_final_versionen_US
dc.identifier.doi10.1245/s10434-011-1846-5en_US
dc.identifier.pmid21732144-
dc.identifier.pmcidPMC3264855-
dc.identifier.scopuseid_2-s2.0-84856670523-
dc.identifier.hkuros187599-
dc.identifier.volume19en_US
dc.identifier.issue2en_US
dc.identifier.spage584en_US
dc.identifier.epage590en_US
dc.identifier.eissn1534-4681en_US
dc.identifier.isiWOS:000299483200034-
dc.publisher.placeUnited States-
dc.description.otherSpringer Open Choice, 21 Feb 2012en_US
dc.identifier.citeulike9545492-

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