Ultrasound-Guided Radiofrequency Ablation for the Treatment of Primary Hyperparathyroidism in Elderly Patients

This study aimed to assess the efficacy and safety of ultrasound-guided radiofrequency ablation (RFA) in elderly patients with primary hyperparathyroidism (PHPT).

This retrospective cohort study included patients aged ≥ 60 years with PHPT who underwent ultrasound-guided RFA at a single center between May 2021 and May 2025. A total of 36 patients were analyzed. Laboratory parameters, including serum calcium and intact parathyroid hormone (iPTH), were assessed before and after the procedure. All patients were followed for at least 6 months. Cure was defined as normalization of both serum calcium and iPTH levels during follow-up. Procedural outcomes, complications, and factors associated with treatment response were evaluated.

The mean age of the cohort was 70.4 (±8.69) years. After a single RFA session, 28 of 36 patients achieved a cure. When repeat procedures were included, the overall cure rate increased to 83.3% (30/36). The key procedure-related adverse events were postoperative mild pain and hoarseness. Hoarseness was transient in most cases; permanent hoarseness occurred in one patient. No major life-threatening complications were observed. Baseline characteristics did not differ significantly between cured and non-cured patients. Patients who developed hoarseness were older and had lower baseline magnesium levels than those without hoarseness.

Ultrasound-guided RFA appears to be an effective and safe minimally invasive treatment option for selected elderly patients with PHPT, achieving acceptable cure rates with a favorable safety profile. RFA may represent a valuable alternative for elderly or frail patients who are at increased surgical risk. Prospective studies with larger cohorts and longer follow-up are warranted to confirm these findings.