Evaluation of efficacy of ultrasound‐guided microwave ablation in primary hyperparathyroidism

Zhang, Mingzhu; Gao, Yanjing; Xiao-juan, Zhang; Ding, Zhaoyan; Wang, Xinya; Jiang, Wenbin; Zhao, Cheng

doi:10.1002/jcu.23134

Cited by 5 publications

(3 citation statements)

References 36 publications

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“…Through high-frequency vibration, polar molecules (mostly water molecules) generate heat and rapidly rising temperature to 150 degrees Celsius results in cell dehydration necrosis (40). The MWA advantages include rapid temperature rise, high heat, short treatment period, extensive ablation range, and total inactivation of tumor tissue (41).…”

Section: Microwave Ablationmentioning

confidence: 99%

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Current status and perspectives of ultrasound-guided ablation techniques in patients with primary hyperparathyroidism

et al. 2023

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Primary hyperparathyroidism (PHPT) is an endocrine disorder characterized by elevated or inappropriately parathormone levels. The most common cause of PHPT is solitary parathyroid adenoma (80-85%). Parathyroid surgery generally encompasses symptomatic PHPT and asymptomatic patients who meet the surgical guideline criteria. If surgery is contraindicated, several non-surgical ablative techniques can be conducted to eliminate the pathological parathyroid tissue, which causes tissue necrosis in the affected gland. This review aims to look into the most recent studies on the efficacy of percutaneous ethanol injection therapy (PEIT), laser ablation (LA), radiofrequency ablation (RFA), microwave ablation (MWA), and high-intensity focused ultrasound (HIFU) in treatment of PHPT and analyze their application prospects. PEIT is a classic method that is less commonly used nowadays. The analysis of thermal ablation methods revealed that LA is inefficient and requires considerable repetition. Meanwhile, the MWA and RFA have a cure rate of over 85% and fewer complications; it seems that they have the potential to replace surgical methods in the future.

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Section: Microwave Ablationmentioning

confidence: 99%

“…Previously, Zhang et al perform MWA for PHPT treatment in 35 cases with six months follow-up. They concluded that MWA could significantly reduce serum PTH, calcium, and phosphorus levels; it was also relatively safe and long lasting in treating PHPT patients (41).…”

Section: Microwave Ablationmentioning

confidence: 99%

Current status and perspectives of ultrasound-guided ablation techniques in patients with primary hyperparathyroidism

et al. 2023

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“…Longitudinal studies in PHP are mostly focused on post-operatory outcome between 1 and 3 years (up to 10 years) [13,75]. When assessing the early post-operatory QoL, the impact of PTx itself should be addressed [37,76,77]. A massive progress has been registered during the modern era of parathyroid surgery regardless of the initial clinical picture and associated complications/co-morbidities as seen in multiple endocrine neoplasia [53,77,78].…”

Section: Longitudinal Data On Php: Should Qol Assessment Find Its Way?mentioning

confidence: 99%

Neuroendocrine Parathyroid Tumors: Quality of Life in Patients with Primary Hyperparathyroidism

et al. 2023

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Tumors of the parathyroid glands, when associated with PTH (parathyroid hormone) excess, display a large area of complications; in addition to the classical clinical picture of primary hyperparathyroidism (PHP), a complex panel of other symptoms/signs can be identified, including memory and cognitive impairment, chronic asthenia/fatigue, reduced muscle functionality, depressive mood, non-specific bone pain, and loss of sleep quality. The perception of quality of life (QoL) can be supplementarily enhanced by their progressive onset, which makes many patients not be fully aware of them. Their improvement was reported very early after parathyroidectomy (PTx), yet the level of statistical evidence does not qualify these non-classical elements as standalone indications for PTx. Our objective is introducing an up-to-date on QoL scores with regards to the patients diagnosed with PHP, particularly taking into consideration PHP management from baseline to post-operatory outcome, including in cases with multiple endocrine neoplasia. This is a narrative review of literature. We revised full-length papers published in English through PubMed research conducted between January 2018 and May 2023 by using the key words “quality of life” and “primary hyperparathyroidism”. We particularly looked at data on self-reported QoL (through questionnaires). We excluded from the search the studies focused on non-PTH related hypercalcemia, secondary, and/or renal/tertiary hyperparathyroidism, and vitamin D supplementation. Overall, we identified 76 papers and selected for the final analysis 16 original studies on QoL and PHP (a total of 1327 subjects diagnosed with syndromic and non-syndromic PHP). The studies with the largest number of individuals were of 92, 104, 110, 134, 159, as well as 191. A few cohorts (n = 5) were of small size (between 20 and 40 patients in each of them). Concerning the study design, except for 2 papers, all the mentioned studies provided longitudinal information, particularly the timeframe from baseline (before PTx) and after surgery. The post-operatory follow-up was of 3–6 months, but mostly between 1 and 3 years (maximum a decade of surveillance). The age of the patients varies between medians of 56, 62, 64, and 68 years. Most frequent questionnaires were SF-36, PHPQoL, and PAS. Despite not being unanimously similar, an overall reduced score of QoL in patients with PHP versus controls was registered, as well as general improvement following PTx. Variations of QoL results might have a multifactorial background from different comorbidities, studied populations, technical aspects of collecting the data, etc. QoL scores in PHP represents a complex heterogeneous picture, from their correlation with clinical features and lab assays (e.g., the level of serum calcium), the associated comorbidities (such as multiple endocrine neoplasia syndromes), up to the assessment of the QoL improvement after parathyroidectomy (PTx). While current studies do not unanimously agree on each QoL domain, the assessment of QoL might represent a supplementary argument to consider when deciding for PTx, especially in asymptomatic cases and in patients who do not fit into well-known categories of surgery candidates, according to current guidelines, thus assessing QoL in PHP is part of a current research gap. QoL evaluation in PHP remains an open issue, towards which awareness should be cultivated by both endocrinologists and surgeons. The introduction of a routine evaluation of the QoL scores in patients, as well as the selection of the most appropriate questionnaire(s), represents an open chapter thus awareness in mandatory.

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Evaluation of efficacy of ultrasound‐guided microwave ablation in primary hyperparathyroidism

Zhang

Gao

Xiao-juan

et al. 2022

J of Clinical Ultrasound

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Purpose: We aimed to evaluate the clinical efficacy and safety of ultrasonographically (US)-guided percutaneous microwave ablation (MWA) in the treatment of primary hyperparathyroidism (PHPT). Methods: A total of 35 patients who received MWA treatment in our hospital between August, 2019 and January, 2021 were retrospectively analyzed. Serum parathyroid hormone (PTH), calcium, phosphorus levels, and improvement in clinical symptoms were recorded before and after MWA. All patients were followed up for 6 months. Paired-sample t-tests and paired sample Wilcoxon signed-rank tests were used to indicate PTH, calcium, and P levels before and after ablation. Postoperative complications were statistically analyzed to evaluate the therapeutic effect of MWA on PHPT patients. Results: A total of 38 parathyroid nodules in 35 PHPT patients were completely ablated at one time. These results indicated that MWA could effectively destroy parathyroid tissue and decrease the concentrations of PTH, calcium, and phosphorus compared with those before MWA, and the effect was sustained. Moreover, MWA improved clinical symptoms, and improved quality of life of patients. None of patients developed tracheal and esophageal injuries, peripheral hematoma, infection, or other serious complications. Conclusion: US-guided MWA has shown to be an effective and safe approach to treat PHPT patients.

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Evaluation of efficacy of ultrasound‐guided microwave ablation in primary hyperparathyroidism

Cited by 5 publications

References 36 publications

Current status and perspectives of ultrasound-guided ablation techniques in patients with primary hyperparathyroidism

Current status and perspectives of ultrasound-guided ablation techniques in patients with primary hyperparathyroidism

Neuroendocrine Parathyroid Tumors: Quality of Life in Patients with Primary Hyperparathyroidism

Evaluation of efficacy of ultrasound‐guided microwave ablation in primary hyperparathyroidism

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