Risk factors for hypocalcaemia after completion hemithyroidectomy in thyroid cancer

Area of Science:

• Endocrinology
• Surgical Oncology
• Neurosurgery

Background:

• Hypocalcaemia (HC) is a frequent complication following differentiated thyroid cancer surgery.
• While risk factors for HC after total thyroidectomy (TE) are known, fewer studies address HC after completion TE.
• This study aimed to identify HC risk factors after completion TE and compare incidence rates with primary TE.

Purpose of the Study:

• To identify risk factors for hypocalcaemia (HC) after completion thyroidectomy (TE).
• To compare the incidence of HC after completion TE with primary TE.
• To analyze the relationship between preoperative factors and postoperative HC.

Main Methods:

• Retrospective cohort study of patients undergoing completion TE (2002-2013).
• Comparison of patients with hypocalcaemia (group 1) versus normocalcaemia (group 2).
• Analysis of gender, age, cancer type, time interval, pre/postoperative calcium and PTH levels, clinical signs, and calcium substitution.

Main Results:

• 33% (12/34) of patients developed hypocalcaemia; 9% (3/34) developed hypoparathyroidism.
• Significant differences observed in postoperative PTH (25.1 vs 37.6 pg/ml) and calcium levels (1.87 vs 2.27 mmol/l) between groups.
• Low preoperative serum calcium level was the only dominant predictor of postoperative hypocalcaemia.

Conclusions:

• The incidence of hypocalcaemia (33%) and hypoparathyroidism (9%) after completion TE is comparable to primary TE.
• Low preoperative calcium levels are a significant risk factor for postoperative hypocalcaemia after completion TE.
• Predicting hypocalcaemia remains challenging due to its multifactorial nature.