Parathyroidectomy is safe and improves symptoms in elderly patients with primary hyperparathyroidism (PHPT).
OBJECTIVE: Parathyroidectomy for primary hyperparathyroidism (PHPT) is curative in over 95% of cases. Although PHPT affects up to 2% of the elderly population, whose life expectancy may be a decade or more, such patients may be denied surgery because of perceived risk. This study investigates the o...
| Huvudupphovsmän: | , , , , |
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| Materialtyp: | Journal article |
| Språk: | English |
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2009
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| _version_ | 1826257425328504832 |
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| author | Stechman, M Weisters, M Gleeson, F Sadler, G Mihai, R |
| author_facet | Stechman, M Weisters, M Gleeson, F Sadler, G Mihai, R |
| author_sort | Stechman, M |
| collection | OXFORD |
| description | OBJECTIVE: Parathyroidectomy for primary hyperparathyroidism (PHPT) is curative in over 95% of cases. Although PHPT affects up to 2% of the elderly population, whose life expectancy may be a decade or more, such patients may be denied surgery because of perceived risk. This study investigates the outcomes of surgery for PHPT in the elderly. DESIGN AND PATIENTS: Consecutive patients with PHPT treated at a tertiary referral centre over 5 years. MEASUREMENTS: A prospective database recorded clinical, biochemical and pathological information. Pasieka's parathyroid symptom scores were obtained pre-operatively and post-operatively, from a recent subgroup of 70 consecutive patients. Deaths during follow-up were identified using the NHS Strategic Tracing Service. Statistical analysis was performed with spss v12.0. RESULTS: Between November 2002 and October 2007, 224 patients (17-89 years) underwent surgery for PHPT. In the subgroup comprising patients aged >75 years there was a significantly greater proportion of women (47/56 vs. 52/81, P < 0.05). Pre-operative indices of these patients were similar to younger patients, as were proportions undergoing minimally invasive parathyroidectomy (n = 134) or bilateral neck exploration (n = 90). Patients >75 years had a longer hospital stay (1.6 vs. 0.8 days, P = 0.003). Pasieka's symptom scores improved significantly at 3-6 months postoperatively in all age groups. During a minimum median follow-up of 22 months, there were seven patients with persistent/recurrent disease. Median 2-year survival of those aged 60-74 and those over 75 ranged from 85-90%. CONCLUSION: Parathyroidectomy is safe in the elderly and is associated with a significant improvement in symptoms. As survival after operation is similar to younger patients, surgery should be considered in all elderly patients with PHPT. |
| first_indexed | 2024-03-06T18:18:01Z |
| format | Journal article |
| id | oxford-uuid:054c2a95-7489-4402-8f76-f9b2c9dc65f9 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T18:18:01Z |
| publishDate | 2009 |
| record_format | dspace |
| spelling | oxford-uuid:054c2a95-7489-4402-8f76-f9b2c9dc65f92022-03-26T08:56:18ZParathyroidectomy is safe and improves symptoms in elderly patients with primary hyperparathyroidism (PHPT).Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:054c2a95-7489-4402-8f76-f9b2c9dc65f9EnglishSymplectic Elements at Oxford2009Stechman, MWeisters, MGleeson, FSadler, GMihai, R OBJECTIVE: Parathyroidectomy for primary hyperparathyroidism (PHPT) is curative in over 95% of cases. Although PHPT affects up to 2% of the elderly population, whose life expectancy may be a decade or more, such patients may be denied surgery because of perceived risk. This study investigates the outcomes of surgery for PHPT in the elderly. DESIGN AND PATIENTS: Consecutive patients with PHPT treated at a tertiary referral centre over 5 years. MEASUREMENTS: A prospective database recorded clinical, biochemical and pathological information. Pasieka's parathyroid symptom scores were obtained pre-operatively and post-operatively, from a recent subgroup of 70 consecutive patients. Deaths during follow-up were identified using the NHS Strategic Tracing Service. Statistical analysis was performed with spss v12.0. RESULTS: Between November 2002 and October 2007, 224 patients (17-89 years) underwent surgery for PHPT. In the subgroup comprising patients aged >75 years there was a significantly greater proportion of women (47/56 vs. 52/81, P < 0.05). Pre-operative indices of these patients were similar to younger patients, as were proportions undergoing minimally invasive parathyroidectomy (n = 134) or bilateral neck exploration (n = 90). Patients >75 years had a longer hospital stay (1.6 vs. 0.8 days, P = 0.003). Pasieka's symptom scores improved significantly at 3-6 months postoperatively in all age groups. During a minimum median follow-up of 22 months, there were seven patients with persistent/recurrent disease. Median 2-year survival of those aged 60-74 and those over 75 ranged from 85-90%. CONCLUSION: Parathyroidectomy is safe in the elderly and is associated with a significant improvement in symptoms. As survival after operation is similar to younger patients, surgery should be considered in all elderly patients with PHPT. |
| spellingShingle | Stechman, M Weisters, M Gleeson, F Sadler, G Mihai, R Parathyroidectomy is safe and improves symptoms in elderly patients with primary hyperparathyroidism (PHPT). |
| title | Parathyroidectomy is safe and improves symptoms in elderly patients with primary hyperparathyroidism (PHPT). |
| title_full | Parathyroidectomy is safe and improves symptoms in elderly patients with primary hyperparathyroidism (PHPT). |
| title_fullStr | Parathyroidectomy is safe and improves symptoms in elderly patients with primary hyperparathyroidism (PHPT). |
| title_full_unstemmed | Parathyroidectomy is safe and improves symptoms in elderly patients with primary hyperparathyroidism (PHPT). |
| title_short | Parathyroidectomy is safe and improves symptoms in elderly patients with primary hyperparathyroidism (PHPT). |
| title_sort | parathyroidectomy is safe and improves symptoms in elderly patients with primary hyperparathyroidism phpt |
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