Evaluation of the efficacy of radiofrequency ablation therapy in cases with parathyroid adenoma

TL;DR

This study evaluates radiofrequency ablation as a treatment for parathyroid adenoma, finding it effective in normalizing calcium levels in most patients.

Contribution

The study provides new clinical evidence supporting radiofrequency ablation as an alternative treatment for primary hyperparathyroidism.

Findings

Radiofrequency ablation normalized serum calcium levels in 86.6% of patients after one year.

More than half of patients had normocalcemic hyperparathyroidism at one-year follow-up.

The biochemical cure rate was 30.2% at one year with significant changes in calcium and PTH levels.

Abstract

Radiofrequency ablation of solitary parathyroid adenoma has been used to treat primary hyperparathyroidism (pHPT) in high-risk patients for parathyroidectomy. This study aimed to evaluate the clinical efficacy of radiofrequency ablation for treating pHPT in patients with parathyroid adenomas.

The sample for this retrospective study comprised all consecutive patients with solitary parathyroid adenoma treated with radiofrequency ablation between 2013 and 2021. Patients’ baseline serum calcium and parathyroid hormone (PTH) values were obtained. The patients were followed up with serial biochemical measurements after the intervention, then at the first-week, first-month, third-month, sixth-month, and twelfth-month follow-ups. The study’s primary outcome was a biochemical cure, defined as the reestablishment of normal serum calcium and PTH levels, persisting for at least 6 months after the ablation.

The changes in the serum calcium and PTH levels were significant (p < 0.05). The biochemical cure rate was 30.2% at 1 year. At the end of 1 year, the rate of patients with normal serum calcium levels was 86.6%, whereas the rate of patients with normal serum calcium and higher PTH levels was 55.8%.

Radiofrequency ablation of a solitary parathyroid adenoma may be considered an alternative treatment for pHPT, given that more than half of the cases investigated in this study had normocalcemic hyperparathyroidism at 1 year.

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