SURVIVAL AFTER SURGICAL-TREATMENT FOR PRIMARY HYPERPARATHYROIDISM

Background. Reports have suggested that patients with primary hyperpar athyroidism (pHPT) are at increased risk for premature death, even whe n they reach normocalcemia. This study addresses factors that may be o f relevance for long term outcome. Methods, Between 1980 and 1984, 105 2 patients (27% men and 73% women; median age, 59 years) underwent ini tial cervical exploration for pHPT. Long-term follow-up was obtained w ith regard to overall survival and cause of death. By using univariate and multivariate (Cox) survival analysis, subgroups of patients were compared. Results, Median follow-up was 12 years (range, 0 to 15 years ). Overall, survival was not decreased compared with the expected surv ival of a gender and age-matched midwest population. Survival was bett er in patients with a history of kidney stones (p = 0.044), without os teoporosis (p = 0.004), and without muscle weakness (p = 0.013). Concl usions. Decreased long-term survival was not evident in this study. Ag e at the time of initial surgical treatment and the degree of endocrin e activity of the diseased glands appear to be the most impor tant ind ependent prognostic factors for survival. Comparison of these data to prior Scandinavian data is not justified, principally because of the l ess advanced stage of disease in this study.