Back to my future: life after surgery for tertiary hyperparathyroidism

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.

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.

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.

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.