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Study Details Long-Term Quality of Life Improvements After Parathyroidectomy in Primary Hyperparathyroidism

New research provides an overview of the long-term quality of life benefits achieved after parathyroidectomy for people with primary hyperparathyroidism.

A systematic review of English-language published studies published from June 1998 through February 15, 2021, results of the study detail the improvements in quality of life observed up to 10 years after parathyroidectomy among people with primary hyperparathyroidism.

“This systematic review brings together 20 years of research investigating QOL after treatment with parathyroidectomy for patients with primary hyperparathyroidism,” wrote investigators. “Based on these 31 studies, there is strong evidence in the literature that parathyroidectomy is associated with improvements in preoperative, nonspecific, neurocognitive symptoms and quality of life, and these improvements are sustained in the long term.”

Led by a trio of investigators from the Department of Surgery at the Medical College of Wisconsin, the research effort was undertaken with the intent of describing the impact of undergoing parathyroidectomy for primary hyperparathyroidism on long-term quality of life and specific quality of life properties among this patient population. With this in mind, investigators designed their systematic review to evaluate these associations among studies on the subject published in the English language with a minimum of 1 year of follow-up data within the PubMed and Scopus databases from June 1998 through February 15, 2021.

Using Medical Subject Heading terms for hyperparathyroidism, parathyroid hormone, parathyroidectomy, hypercalcemia, and quality of life, investigators identified 31 studies conducted in 14 countries for inclusion in their systematic review. Of note, the original search had returned 3008 studies, with the majority of these studies being eliminated from inclusion due to being duplicates or not meeting inclusion criteria.

Of the 31 studies included, 22 were prospective cohort studies, 5 were randomized clinical trials, 1 was a cases series, 1 was a cross-sectional study, 1 was a case-control study, and 1 was a retrospective cohort study. Regarding quality of life assessments, 21 studies used the 12-item Short-Form Health Survey, a general tool to measure equality of life, and 8 used a disease-specific quality of life measurements, with the remaining using a combination of 10 additional quality of life tools.

Upon analysis, 87% (n=27) of the 31 studies demonstrated significant score improvement in long-term quality of life following parathyroidectomy, including a single study that provided evidence of continued improvement in quality of life 10 years after parathyroidectomy. Investigators highlighted 13% (n=4) of studies included in the review reported mixed results.

“This systematic review suggests that surgical intervention with parathyroidectomy is associated with improved and sustained long-term QOL in patients with primary hyperparathyroidism. This review identifies 2 key gaps in the current guidelines: a lack of standardized methodology for assessing quality of life and a lack of specificity regarding which components of quality of life should be considered when counseling patients about parathyroidectomy,” investigators added.

This study, “Long-term Quality of Life After Parathyroidectomy for Primary Hyperparathyroidism,” was published in JAMA Surgery.