PMID- 14668715
OWN - NLM
STAT- MEDLINE
DCOM- 20040129
LR  - 20190917
IS  - 0039-6060 (Print)
IS  - 0039-6060 (Linking)
VI  - 134
IP  - 6
DP  - 2003 Dec
TI  - Results of initial operation for hyperparathyroidism in patients with multiple 
      endocrine neoplasia type 1.
PG  - 858-64; discussion 864-5
AB  - BACKGROUND: Hyperparathyroidism in patients with multiple endocrine neoplasia 
      type 1 (MEN1) is characterized by multiglandular disease and a propensity for 
      recurrence after parathyroidectomy (PTx). This study analyzes outcomes of a 
      cohort of MEN1 patients undergoing initial PTx at one institution. METHODS: 
      Between April 1960 and September 2002, 92 patients with MEN1 underwent initial 
      PTx. Outcomes were analyzed based on extent of parathyroid resection. RESULTS: 
      Fourteen percent had 2.5 or fewer glands resected, 69% had subtotal PTx, and 17% 
      had total PTx (88% with immediate autotransplantation). The initial surgical cure 
      rate was 98%. Excluding 6 patients lost to follow-up, 33% have developed 
      recurrent hyperparathyroidism (in 46% after < or =2.5 PTx, in 33% after subtotal, 
      and in 23% after total PTx). Median recurrence-free survival was not 
      statistically significantly different between subtotal versus total PTx, but it 
      was longer for subtotal and total PTx compared with lesser resection (16.5 vs 7.0 
      years, respectively, P=.03). The incidence of severe hypoparathyroidism was 46% 
      after total versus 26% after subtotal PTx. CONCLUSIONS: Subtotal and total PTx 
      result in durable control of MEN1-associated hyperparathyroidism and have longer 
      recurrence-free intervals compared with lesser resection. The high incidence of 
      severe hypoparathyroidism after total PTx suggests that subtotal PTx is the 
      initial operation of choice in this setting.
FAU - Elaraj, Dina M
AU  - Elaraj DM
AD  - Surgery Branch, Center for Cancer Research, National Cancer Institute, National 
      Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA.
FAU - Skarulis, Monica C
AU  - Skarulis MC
FAU - Libutti, Steven K
AU  - Libutti SK
FAU - Norton, Jeffrey A
AU  - Norton JA
FAU - Bartlett, David L
AU  - Bartlett DL
FAU - Pingpank, James F
AU  - Pingpank JF
FAU - Gibril, Fathia
AU  - Gibril F
FAU - Weinstein, Lee S
AU  - Weinstein LS
FAU - Jensen, Robert T
AU  - Jensen RT
FAU - Marx, Stephen J
AU  - Marx SJ
FAU - Alexander, H Richard
AU  - Alexander HR
LA  - eng
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Surgery
JT  - Surgery
JID - 0417347
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Hyperparathyroidism/etiology/*surgery
MH  - Male
MH  - Middle Aged
MH  - Multiple Endocrine Neoplasia Type 1/complications/*surgery
MH  - Parathyroidectomy/*methods
MH  - Recurrence
MH  - Survival Analysis
MH  - Treatment Outcome
EDAT- 2003/12/12 05:00
MHDA- 2004/01/30 05:00
CRDT- 2003/12/12 05:00
PHST- 2003/12/12 05:00 [pubmed]
PHST- 2004/01/30 05:00 [medline]
PHST- 2003/12/12 05:00 [entrez]
AID - S0039606003004069 [pii]
AID - 10.1016/s0039-6060(03)00406-9 [doi]
PST - ppublish
SO  - Surgery. 2003 Dec;134(6):858-64; discussion 864-5. doi: 
      10.1016/s0039-6060(03)00406-9.