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Updated: Sep 9, 2025
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Published on: August 17, 2022
Extent of Surgical Resection and Predictors of Outcomes in MEN1-related Hyperparathyroidism: A Systematic Review and
Wellington Alves Filho1, Francisco Januário Farias Pereira Filho1, Valeria Maria Caland Morais1
1Department of Head and Neck Surgery, Faculty of Medicine, Hospital Universitário Walter Cantidio, Federal University of Ceará, Fortaleza 60430-372, Brazil.
Context:
Primary hyperparathyroidism (PHPT) is the earliest and most frequent manifestation of multiple endocrine neoplasia type 1 (MEN1). The optimal surgical extent remains controversial due to the tradeoff between recurrence and permanent hypoparathyroidism.
Objective:
To evaluate outcomes of different surgical approaches in MEN1-related PHPT and assess preoperative biochemical predictors through systematic review and meta-analysis.
Data Sources:
MEDLINE, PubMed, Embase.com, LILACS, and CENTRAL were searched from inception to April 2025, following PRISMA guidelines (PROSPERO: CRD420251027970).
Study Selection:
We included studies on adult MEN1-related PHPT patients undergoing parathyroidectomy with reported recurrence, hypoparathyroidism, and preoperative biochemical data.
Data Extraction:
Two reviewers independently extracted data and assessed study quality. Random-effects models were used to pool risk ratios (RR) with 95% confidence intervals (CI). Meta-regression evaluated associations with preoperative PTH, calcium, and phosphorus.
Data Synthesis:
Thirteen studies (915 patients) were included. Less-than-subtotal parathyroidectomy (
Conclusion:
Conservative surgery reduces hypoparathyroidism but increases recurrence. Personalized surgical strategies are essential in MEN1-related PHPT.
