US-guided microwave ablation for primary hyperparathyroidism: a safety and efficacy study

Fan, Bin; He, Xiaowei; Chen, Huanhuan; Zhang, Weiming; Tang, Wei

doi:10.1007/s00330-019-06078-y

Cited by 33 publications

(44 citation statements)

References 31 publications

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“…As a classical treatment method, the cure rate of a parathyroidectomy is 95-98%, which is higher than that found in the present study (4,36). However, a comparative study demonstrated that MWA and surgical resection provided comparable short-term cure rates for PHPT (82.1% vs. 89.3%, respectively, p = 0.705) (20). A future study with a longer follow-up period needs to be undertaken that compares MWA to parathyroidectomy for PHPT.…”

Section: Discussioncontrasting

confidence: 75%

“…As another minimally invasive treatment, microwave ablation (MWA) has also been used successfully in recent years (17)(18)(19). For PHPT management, the results of MWA and parathyroidectomy have been comparable in terms of the cure rate and the number of treatment complications (20). However, the sample sizes of that study were small, and the follow-up durations were short.…”

Section: Mwa Proceduresmentioning

confidence: 99%

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Clinical Study on Safety and Efficacy of Microwave Ablation for Primary Hyperparathyroidism

Wei

Peng

et al. 2020

Korean J Radiol

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Objective: To evaluate the safety, feasibility, and efficacy of microwave ablation (MWA) for the treatment of primary hyperparathyroidism (PHPT). Materials and Methods: This study enrolled 67 PHPT patients (22 men, 45 women; mean age, 56.0 ± 16.3 years; range, 18-83 years) from January 2015 to December 2018. The laboratory data, including the serum intact parathyroid hormone (iPTH), calcium, phosphorus, and alkaline phosphatase (ALP) levels, were evaluated before MWA and again 2 hours, 1 day, 7 days, 1 month, 3 months, 6 months, 12 months, 18 months, and 24 months after. Results: Complete ablation was achieved with all 72 hyperplastic parathyroid glands found on the 67 patients enrolled, 64 of whom were treated in one session and 3 were treated over two sessions. The technical success rate was 100%. The median follow-up time was 13.6 months (range, 10.0-31.1 months). The clinical success rate was 89.4%. The volume reduction rate was 79.4% at 6 months. Compared to pre-MWA, the serum iPTH, calcium, phosphorus, and ALP levels had significantly improved 6 months post-MWA (iPTH, 157.3 pg/mL vs. 39.2 pg/mL; calcium, 2.75 ± 0.25 mmol/L vs. 2.34 ± 0.15 mmol/L; phosphorus, 0.86 ± 0.20 mmol/L vs. 1.12 ± 0.22 mmol/L; ALP, 79 U/L vs. 54 U/L, respectively; all, p < 0.01). Hoarseness was a major complication in 4 patients (6.0%), but it improved spontaneously within 2-3 months. Conclusion: MWA is safe, feasible, and effective for the treatment of PHPT.

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Section: Discussioncontrasting

confidence: 75%

Section: Mwa Proceduresmentioning

confidence: 99%

Clinical Study on Safety and Efficacy of Microwave Ablation for Primary Hyperparathyroidism

Wei

Peng

et al. 2020

Korean J Radiol

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“…Mean VPG at baseline was 0. 43 Serum calcium was significantly reduced at 6 months after thermal ablation on the PHPT (MD ¼ À0.31, 95% CI ¼ À0.46 to À0.17, p < 0.001; Figure 5). The value of Cohen's d was 1.19, and the effect size was defined as large.…”

Section: Calcium Levelmentioning

confidence: 94%

“…Five articles were included in the final analysis after reviewing. One prospective study and 4 retrospective studies were included in this meta-analysis [25,27,[42][43][44]. In the study by Liu et al [44], patients in another group received parathyroidectomy for PHPT.…”

Section: Literature Searchmentioning

confidence: 99%

Efficacy and safety of US-guided thermal ablation for primary hyperparathyroidism: a systematic review and meta-analysis

Huang

et al. 2020

International Journal of Hyperthermia

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Purpose: To summarize the published literature on thermal ablation for primary hyperparathyroidism (PHPT) and to evaluate the effectiveness and safety of thermal ablation as a novel treatment strategy. Materials and methods: Two authors carried out the literature search using four databases independently, including PubMed, Embase, Cochrane, and Web of Science. The meta-analysis included prospective and retrospective data that compared post-ablative outcomes to pre-ablative values. The primary outcomes were parathyroid hormone (PTH), serum calcium and volume of the parathyroid gland (VPG). Results: From the 184 original articles, five studies (4 retrospective studies and 1 prospective study) examining 84 patients met the inclusion criteria. The meta-analysis showed significant reduction of PTH at 3 (standardized mean difference (SMD) ¼ À1.09, 95% confidence index (CI) ¼ À1.42 to À0.76, p < 0.001) and 6 months (SMD ¼ À1.13, 95% CI ¼ À1.46 to À0.80, p < 0.001) after thermal ablation. Serum calcium level was significantly reduced at 3 (mean difference (MD) ¼ À0.31, 95% CI ¼ À0.50 to À0.12, p ¼ 0.001) and 6 months (MD ¼ À0.31, 95% CI ¼ À0.46 to À0.17, p < 0.001) after thermal ablation. There was no significant difference between pre-ablative VPG and that of 6 months after ablation (MD ¼ À0.30, 95% CI ¼ À0.70 to 0.09, p ¼ 0.13). The most common complications were transient dysphonia and subcutaneous edema. No major complications or death occurred. Conclusion: Thermal ablation is effective and safe for treatment of PHPT. PTH and calcium levels were reduced significantly at 3 and 6 months after thermal ablation.

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“…Image-guided thermal ablation has been applied to the treatment of hyperparathyroidism (HPT) in recent years [1][2][3][4]. As an ablation method, US-guided percutaneous microwave ablation (MWA) has yielded promising clinical results [5][6][7][8][9]. Since this technique causes minimal injuries and effectively reduces intact parathyroid hormone (iPTH) levels, it has been gradually accepted in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Complications encountered in the treatment of primary and secondary hyperparathyroidism with microwave ablation – a retrospective study

Wei

Peng

Zhao

et al. 2019

International Journal of Hyperthermia

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Purpose: To evaluate the complications encountered during microwave ablation (MWA) for primary and secondary hyperparathyroidism (HPT). Materials and methods: The retrospective study enrolled 213 secondary hyperparathyroidism (SHPT) and 51 primary hyperparathyroidism (PHPT) patients who received MWA between July 2015 and September 2018. The major and minor treatment-related complications were documented. The baseline data, clinical parameters, laboratory indices and characteristics of the parathyroid glands were analyzed to assess the risk factors associated with these complications. Results: The incidence of post-MWA complications in HPT patients was 12.1% (32/264). In total, five (5/264, 1.9%) patients with SHPT had major complications, including aphonia/hoarseness (n ¼ 4) and Horner syndrome (n ¼ 1). A total of 27 (10.2%, 27/264) HPT patients had minor complications, including neck hematoma (0.8%, 2/264), bucking (4.2%, 11/264) and phonasthenia (5.3%, 14/264). The incidence of severe hypocalcemia (SH) after MWA was 18.2%. Cutaneous necrosis occurred in two SH patients after intravenous calcium supplementation. There were no significant differences in the incidence of overall complications, major complications and minor complications between SHPT and PHPT patients (12.7% vs 9.8%, p ¼ 0.811; 2.3% vs 0, p ¼ 0.587; 10.3% vs 9.8%, p ¼ 1.000). A history of parathyroidectomy (PTX) (p ¼ 0.031) and multiple symptoms (p ¼ 0.000) were risk factors for the occurrence of complications in SHPT patients. One patient sustained a permanent injury to a unilateral recurrent laryngeal nerve (RLN), and the two patients who experienced cutaneous necrosis underwent debridement plus autologous skin transplantation. The remaining patients recovered without sequelae. Conclusion: The incidence of major complications was low which only occurred in SHPT patients. Most of the patients with complications recovered spontaneously. MWA is safe for the treatment of HPT.

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US-guided microwave ablation for primary hyperparathyroidism: a safety and efficacy study

Cited by 33 publications

References 31 publications

Clinical Study on Safety and Efficacy of Microwave Ablation for Primary Hyperparathyroidism

Clinical Study on Safety and Efficacy of Microwave Ablation for Primary Hyperparathyroidism

Efficacy and safety of US-guided thermal ablation for primary hyperparathyroidism: a systematic review and meta-analysis

Complications encountered in the treatment of primary and secondary hyperparathyroidism with microwave ablation – a retrospective study

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