Abstract
Background: Microwave ablation has a great potential to treat
primary hyperparathyroidism; but its predictors and the therapeutic
efficiency are not clear enough and so the more investigations are
required.
Aim: The purpose of this study was to explore safety and
predictors of the MWA efficacy in patients with primary
hyperparathyroidism (PHPT) induced by parathyroid adenoma.
Methods: Patients with PHPT treated with MWA were included in
this study. Depending on the treatment efficacy, patients divided into
two groups as response and no response group. Possible predictors as
age, gender, Parathyroid adenoma volume, baseline levels of calcium
(Ca), phosphorous (P), alkaline phosphate (ALP), vitamin D and location
of parathyroid adenoma and the instrumental parameters which are
microwave ablation time and power were compared between two groups. The
resulting possible predictors the MWA efficacy exhibiting statistically
significant difference was investigated by using logistic regression.
Results: Thirty-two patients participated into predictor
analysis for MWA efficacy. Comparison of the values of response and no
response groups in terms possible predictors revealed only the baseline
Ca level as the potential predictor of the efficacy of MWA (P<0.05). Further logistic regression results showed the
baseline Ca level as insignificant to construct a mathematical model to
predict the efficacy of MWA (P = 0.071). Furthermore, a
significant difference in time differences was observed after 1 day of
the MWA treatments in the levels of Ca, P, and PHT except than ALP,
those of which was 30 days later (P <0.001). Later on,
the difference stayed steady until the end of follow up.
Conclusions: MWA is an effective and safe therapy for in
patients with PHPT caused by parathyroid adenoma. Baseline Ca level has
been found as potential but detailed investigations revealed none of the
explored factors as predictive for the assessed patients.
Keywords: Primary hyperparathyroidism, microwave ablation,
predictor, efficacy.