Primary hyperparathyroidism: do perioperative biochemical variables correlate with parathyroid adenoma weight or volume?

Randhawa, P S; Mace, Alasdair; Nouraei, S.A.R.; Stearns, Michael

doi:10.1111/j.1365-2273.2007.01447.x

Cited by 51 publications

(51 citation statements)

References 13 publications

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“…reported a series of 63 patients in whom there was a significant correlation between calcium and PTH levels and PTA weight and volume. More recent studies, which evaluated cohorts of about 70 patients, found no correlation at all …”

Section: Discussionmentioning

confidence: 93%

“…The value of preoperative calcium and PTH levels as a predictor of intraoperative PTA dimensions remains undetermined. Some studies reported a statistically significant correlation between preoperative calcium and PTH levels and PTA weight whereas others failed to support these findings . Furthermore, only two studies addressed the potential association between blood calcium and PTH levels and histological features of PTAs, with inconsistent results: one implied that predominantly, chief‐cell PTAs are associated with more severe clinical manifestations than clear‐cell adenomas but the other found no difference …”

mentioning

confidence: 99%

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Parathyroid adenoma: a comprehensive biochemical and histological correlative study

Stern

Mizrachi

Strenov

et al. 2016

Clinical Otolaryngology

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Section: Discussionmentioning

confidence: 93%

mentioning

confidence: 99%

Parathyroid adenoma: a comprehensive biochemical and histological correlative study

Stern

Mizrachi

Strenov

et al. 2016

Clinical Otolaryngology

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“…In multivariate analysis, patients with PC did not show a statistically significant difference in serum levels of iPTH compared to those with benign PHPT. The relationship between preoperative serum PTH levels and the size of a parathyroid adenoma or carcinoma is controversial (25, 26). In the present study, serum iPTH levels were correlated with tumor size in patients with parathyroid adenoma but not in patients with PC.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Predictive Factors for Parathyroid Carcinoma in Patients with Primary Hyperparathyroidism

et al. 2012

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This study was conducted to review the clinical characteristics of parathyroid carcinoma (PC) and to evaluate potential preoperative predictive factors for PC in patients with primary hyperparathyroidism (PHPT). We performed a retrospective review of electronic medical records of 194 patients with pathologically confirmed PHPT in affiliated teaching hospitals of Seoul National University from January 2000 to March 2011. Adenoma was diagnosed in 171 patients, hyperplasia in 12, and carcinoma in 11. Several biochemical measurements were higher in patients with PC than in patients with benign disease, including serum total calcium (P < 0.001), intact parathyroid hormone (P = 0.003), and alkaline phosphatase (ALP) (P < 0.001). Tumors were larger in PC than in benign disease (P < 0.001). Multivariate analysis revealed that serum ALP level (P < 0.001) and tumor size were associated with PC (P = 0.03). Tumor size and serum ALP level were evaluated as preoperative predictive factors for PC using ROC analyses: a tumor size of 3.0 cm (sensitivity 90.9%, specificity 92.1%) and serum ALP level of 285 IU/L (83.3%, 97.0%) had predictive value for the diagnosis of PC in patients with PHPT. In conclusion, elevated serum ALP and a large parathyroid mass at the time of diagnosis can be helpful to predict PC in patients with PHPT.

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“…However, results from different studies have been variable. Randhawa et al [12] observed no relationship between serum calcium and PTH levels and adenoma weight or volume while other studies [7,13,14] demonstrated significant correlations between preoperative serum calcium and PTH and adenoma weight. No consensus has been reached, however, on whether parathyroid weight alone can predict postoperative hypocalcaemia.…”

Section: Discussionmentioning

confidence: 89%

“…Correlation between serum PTH and adenoma weight has been studied by several authors [7][8][9][10][11][12][13][14], as well as serum calcium and adenoma weight [7]. However, results from different studies have been variable.…”

Section: Discussionmentioning

confidence: 99%

Parathyroid Hormone as a Marker for Predicting the Severity of Hypocalcaemia Following Parathyroidectomy

Sekhar

Nayak

Suhasini

et al. 2015

Indian J Otolaryngol Head Neck Surg

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The purpose of this study is to determine preoperative predictors of the severity of the hypocalcaemia following parathyroidectomy. The case records of 70 patients who underwent parathyroidectomy for primary hyperparathyroidism from 2000 to 2013 was retrospectively studied. Their symptoms at presentation, biochemical parameters serum calcium, parathyroid hormone, alkaline phosphatase and parathyroid size on ultrasound were compared with their serial post-operative serum calcium levels at 24, 48, 72 and 96 h. For the purpose of analysis, patients were divided into three groups. Group 1-asymptomatic, biochemically normal (serum calcium always C8.5 mgs%); Group 2-asymptomatic, biochemically below normal (at least one reading \8.5, but none \8.0); Group 3-symptomatic (any one reading\8.0). No correlation was found between the severity of the presenting symptoms, pre-operative serum calcium levels or the parathyroid size with the post-operative calcium levels in the three groups. Though preoperative serum alkaline phosphatase levels were higher in Group 3, it was not statistically significant (p = 0.069). However, preoperative serum parathyroid hormone levels significantly correlated with postoperative serum calcium levels in all three groups (p = 0.006). Pre-operative serum parathyroid hormone levels may serve as a marker for severe post-operative hypocalcaemia and thus identify patients requiring closer monitoring and longer hospitalization following parathyroidectomy.

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Primary hyperparathyroidism: do perioperative biochemical variables correlate with parathyroid adenoma weight or volume?

Abstract: Biochemical parameters will not accurately predict the size of a parathyroid adenoma. The size of a parathyroid adenoma does not correlate with postoperative calcium levels and is therefore not useful as a predictor of postoperative hypocalcaemia.

Cited by 51 publications

References 13 publications

Parathyroid adenoma: a comprehensive biochemical and histological correlative study

Parathyroid adenoma: a comprehensive biochemical and histological correlative study

Preoperative Predictive Factors for Parathyroid Carcinoma in Patients with Primary Hyperparathyroidism

Parathyroid Hormone as a Marker for Predicting the Severity of Hypocalcaemia Following Parathyroidectomy

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