Back to my future: life after surgery for tertiary hyperparathyroidism

Langenbecks Arch Surg. 2024 Nov 18;409(1):350. doi: 10.1007/s00423-024-03539-x.

Abstract

Purposes: Evaluate the changes in quality of life (QoL) in patients affected by tertiary hyperparathyroidism (THPT) after surgical treatment using the Parathyroidectomy Assessment of Symptoms (PAS) and Short Form-36 (SF-36) questionnaires.

Methods: Single centre longitudinal retrospective, single-institution analysis of 34 patients with THPT and submitted to parathyroidectomy between 2015 and 2021. The PAS and SF-36 questionnaires were administered before surgery and 24 months after discharge.

Results: A significative QoL amelioration was registered in physical SF-36 (42.4 ± 11.7 vs 56.7 ± 9.2; P < 0.001), mental SF-36 (47.3 ± 12.1 vs 61.8 ± 7.9; P < 0.001) and PAS score (582 ± 163 vs 293 ± 141; P < 0.001) with a significative improvement of all the 13 symptoms considered. We found that pre-operative intact parathormone (iPTH) levels, preoperative T-score and time of haemodialysis before RTX were predictors of both PAS and SF-36 mental score modifications. A positive correlation was also fund between pre-operative PAS values and their post operative cutback.

Conclusions: Parathyroidectomy for THPT brings to a concrete amelioration of all the disease-related and nonspecific symptoms with significative improvement of QoL. To develop a tailored approach of every patient's needs, from diagnosis to future treatment, we suggest to introduce the symptoms assessment scale as standard stage in periodic evaluations.

Keywords: Parathyroidectomy; Parathyroidectomy assessment of symptoms; Quality of life; Short Form-36; Tertiary hyperparathyroidism.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Hyperparathyroidism / surgery
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Parathyroidectomy*
  • Quality of Life*
  • Retrospective Studies
  • Surveys and Questionnaires
  • Treatment Outcome