Comparison of Treatment Methods for Primary Hyperparathyroidism
Study Overview
This study compares two treatments for primary hyperparathyroidism (pHPT) caused by a solitary parathyroid adenoma: Ultrasound-guided percutaneous alcohol ablation (PEA) and parathyroidectomy (PTx). PTx is the standard treatment for symptomatic patients, while PEA is a less invasive option for those who cannot undergo surgery.
Research Method
The study involved a randomized trial with patients treated between January 2020 and November 2021. Patients with confirmed pHPT and a solitary adenoma were randomly assigned to either the PTx or PEA group. We assessed complications and lab results at various intervals: 24 hours, 2 weeks, 3 months, and 6 months post-treatment.
Results
A total of 68 patients were analyzed in each group, with 83% being female. The results showed:
- Complete response: 91.1% in the PEA group vs. 98.5% in the PTx group.
- Significant reductions in Calcium, PTH, Phosphorus, and Alkaline phosphatase levels in both groups.
- PEA showed a sensitivity of 75% and specificity of 69% for partial response based on adenoma size.
- PTx group reported significantly higher pain levels.
Conclusion
Both PTx and PEA effectively reduced PTH, serum-adjusted Calcium, and adenoma size. PEA is a viable alternative to PTx, especially for smaller adenomas (less than 425.5 mm3 in volume and 13.5 mm in diameter).
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