The long-term benefit of parathyroidectomy in primary hyperparathyroidism: A 10-year prospective surgical outcome study

Background

Previously, utilizing a disease-specific outcome tool (Parathyroidectomy Assessment Of Symptoms or PAS scores) for hyperparathyroidism (HPT), parathyroidectomy was shown to decrease many of the vague nonspecific symptoms associated with HPT. The purpose of this study was to assess whether this improvement persists in the long term.

Methods

PAS Scores and quality of life (QOL) measures were mailed to patients previously enrolled in the primary HPT study, including the thyroidectomy comparison group. Data were compared pre-operatively, 1 and 10 years after operation.

Results

Of the original 122 HPT patients, 78 (64%) and 39/58 (68%) of the thyroidectomy patients participated. The pre-operative PAS score in the HPT group was 318; this decreased to 177 at 1 year and 189 at 10 years (P < .05). In contrast, thyroidectomy had PAS scores of 170 pre-operatively, 190 at 1 year, and 174 at 10 years (P = .1). HPT patients were more symptomatic pre-operatively compared to the thyroidectomy group (318 vs 170; P < .05), yet at 1 and 10 years, there were no differences. QOL was better in the HPT group at 10 years compared to pre-operatively (P < .05).

Conclusion

This prospective study demonstrates the long-term benefit of parathyroidectomy in primary HPT patients. Decrease of their pre-operative symptoms appears to have contributed to their improved QOL at 10 years.