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Microwave ablation as an efficient therapy for primary hyperparathyroidism: Efficacy and predictors of treatment
Mehmet Sercan Erturk1,2, Bulent Cekic3, Işılay Kalan Sarı1
1Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Health Sciences Antalya Training and Research Hospital, Antalya, Turkey.
Background:
Microwave ablation (MWA) has great potential for the treatment of primary hyperparathyroidism, but as predictors and therapeutic efficiency have not been fully clarified, further investigations are required.
Aim:
The purpose of this study was to explore the predictors of MWA efficacy in patients with primary hyperparathyroidism (PHPT) induced by parathyroid adenoma.
Methods:
The study included patients with PHPT treated with MWA separated into two groups as response and no response group, according to the efficacy of the treatment. The two groups were compared with respect of possible predictors, such as age, gender, parathyroid adenoma volume, baseline levels of calcium (Ca), phosphorous (P), alkaline phosphate (ALP) and vitamin D, localisation of parathyroid adenoma, and instrumental parameters such as microwave ablation time and power. The statistical significance of possible predictors of MWA efficacy was investigated by using logistic regression analysis.
Results:
Evaluation was made of 32 patients in respect of analysing predictors of MWA efficacy. In the comparison of the values of the response and no response groups, only baseline Ca level was determined to be a potential predictor of the efficacy of MWA (P < .05). Further logistic regression results showed the baseline Ca level to be insignificant for the construction of a mathematical model to predict the efficacy of MWA (P = .071). The clinical success rate was 87.5%. Compared with pre-MWA, the serum PTH, calcium, phosphorus and ALP levels were significantly improved at 6 months post-MWA (PTH, 99 (86-154) ng/L vs 50 (46-58) ng/L; calcium, 2.94 (2.81-2.98) mmol/L vs 2.38 (2.28-2.50) mmol/L; phosphorus, 0.87 (0.82-1.01) mmol/L vs 1.16 (1.0-1.3) mmol/L; ALP, 82 (73-98) U/L vs 69 (54-84) U/L, respectively; all, P < .01.
Conclusions:
Although no predictor of treatment success could be determined, MWA might be an effective treatment in patients with PHPT.
