Microwave ablation versus radiofrequency ablation for primary hyperparathyroidism: a multicenter retrospective study

Area of Science:

• Endocrinology and Metabolic Disorders
• Minimally Invasive Surgery
• Interventional Radiology

Background:

• Primary hyperparathyroidism (pHPT) is a common endocrine disorder often requiring intervention.
• Minimally invasive ablation techniques, including microwave ablation (MWA) and radiofrequency ablation (RFA), have emerged as treatment options for pHPT.
• Comparative data on the long-term clinical outcomes of MWA versus RFA in pHPT management are limited.

Purpose of the Study:

• To compare the clinical effectiveness and safety of microwave ablation (MWA) versus radiofrequency ablation (RFA) for primary hyperparathyroidism (pHPT).
• To evaluate key outcomes including ablation cure, clinical cure, recurrence, persistence, and complication rates between MWA and RFA groups.

Main Methods:

• Retrospective analysis of 104 patients with pHPT treated with either MWA or RFA across four centers (January 2015 - March 2020).
• Clinical outcomes assessed included effectiveness (defined by serum calcium and intact parathyroid hormone levels) and complication rates.
• Follow-up duration varied, with a median of 18.7 months for MWA and 12 months for RFA.

Main Results:

• No significant differences were observed in ablation cure rates (88.3% MWA vs. 88.9% RFA) or clinical cure rates (87.0% MWA vs. 82.3% RFA).
• Recurrence and persistent pHPT rates were comparable between MWA and RFA groups (5.2% vs. 3.7% for recurrence; 11.7% vs. 11.1% for persistence).
• Complication rates were similar (9.1% MWA vs. 3.7% RFA), with voice change noted as a major complication in both groups.

Conclusions:

• Both radiofrequency ablation (RFA) and microwave ablation (MWA) are safe and effective treatment modalities for primary hyperparathyroidism (pHPT).
• The study found comparable clinical outcomes, including cure rates and complication profiles, between MWA and RFA.
• Tumor size (maximum diameter < 0.7 cm) was identified as an independent predictor of successful ablation in pHPT.