Parathyroid adenoma weight and the risk of death after treatment for primary hyperparathyroidism.

BACKGROUND

Patients operated on for primary hyperparathyroidism run an increased risk of death, as was found in a previous long-term follow-up of 896 patients.

METHODS

In the present study the adenoma weight was determined in 713 patients with single parathyroid gland disease operated on between 1956 and 1982 and followed up in 1986. The adenoma weight was investigated for its usefulness as a prognostic factor.

RESULTS

The analysis showed that the adenoma weight was significantly related to the risk of death (p < 0.001). Also a relationship was noted between glandular weight and preoperative serum calcium level (p < 0.001), although the serum calcium level had no predictive value in relation to the risk of death beyond that of the adenoma weight. The risk increase was also estimated as a function of adenoma weight. A moderate adenoma weight increase in a patient with primary hyperparathyroidism was found to imply an increased risk of death, corresponding to the increased risk of smokers as compared with nonsmokers.

CONCLUSIONS

The results of this study support surgical treatment at an early stage of primary hyperparathyroidism.