Title :

Recurrence after Surgery for Primary Hyperparathyroidism in 517 Patients with Multiple Endocrine Neoplasia Type 1. An AFCE and GTE study (Association Francophone de Chirurgie Endocrinienne and Groupe d'étude des Tumeurs Endocrines).

Author(s) :

Santucci, Nicolas [Auteur]
Service de Chirurgie Digestive, Cancérologique, Générale, Endocrinienne et Urgences (CHU de Dijon)
Ksiazek, Elea [Auteur]
Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques [CIC-EC]
Pattou, Francois [Auteur]
Recherche translationnelle sur le diabète (RTD) - U1190
Baud, Gregory [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Mirallie, Eric [Auteur]
Hôtel-Dieu de Nantes
Frey, Samuel [Auteur]
Hôtel-Dieu de Nantes
Tresallet, Christophe [Auteur]
Sorbonne Université [SU]
Sébag, Frédéric [Auteur]
Hôpital de la Conception [CHU - APHM] [LA CONCEPTION]
Aix Marseille Université [AMU]
Guérin, Carole [Auteur]
Hôpital de la Conception [CHU - APHM] [LA CONCEPTION]
Aix Marseille Université [AMU]
Mathonnet, Muriel [Auteur]
Université de Limoges [UNILIM]
Christou, Niki [Auteur]
CHU Limoges
Donatini, Gianluca [Auteur]
Centre hospitalier universitaire de Poitiers = Poitiers University Hospital [CHU de Poitiers [La Milétrie]]
Brunaud, Laurent [Auteur]
Centre Hospitalier Régional Universitaire de Nancy [CHRU Nancy]
Gaujoux, Sebastien [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Ménégaux, Fabrice [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Najah, Haythem [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Binquet, Christine [Auteur]
Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques [CIC-EC]
Goudet, Pierre [Auteur]
CHU Dijon
Lifante, Jean Christophe [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]

Journal title :

Ann Surg

Abbreviated title :

Ann Surg

Publication date :

2023-07-01

ISSN :

1528-1140

English keyword(s) :

multiple endocrine neoplasia type 1
primary hyperparathyroidism
recurrence
surgery

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Objective: To assess recurrence according to the type of surgery for primary hyperparathyroidism (pHPT) in multiple endocrine neoplasia type 1 ( MEN1 ) patients and to identify the risk factors for recurrence after the ...
Show more >Objective: To assess recurrence according to the type of surgery for primary hyperparathyroidism (pHPT) in multiple endocrine neoplasia type 1 ( MEN1 ) patients and to identify the risk factors for recurrence after the initial surgery. Background: In MEN1 patients, pHPT is multiglandular, and the optimal extent of initial parathyroid resection influences the risk of recurrence. Methods: MEN1 patients who underwent initial surgery for pHPT between 1990 and 2019 were included. Persistence and recurrence rates after less than subtotal parathyroidectomy (LTSP) and subtotal parathyroidectomy (STP) were analyzed. Patients with total parathyroidectomy with reimplantation were excluded. Results: Five hundred seventeen patients underwent their first surgery for pHPT: 178 had LTSP (34.4%) and 339 STP (65.6%). The recurrence rate was significantly higher after LTSP (68.5%) than STP (45%) ( P < 0.001). The median time to recurrence after pHPT surgery was significantly shorter after LTSP than after STP: 4.25 (1.2-7.1) versus 7.2 (3.9-10.1) years ( P < 0.001). A mutation in exon 10 was an independent risk factor of recurrence after STP (odds ratio = 2.19; 95% CI: 1.31; 3.69; P = 0.003). The 5 and 10-year recurrent pHPT probabilities were significantly higher in patients after LTSP with a mutation in exon 10 (37% and 79% vs 30% and 61%; P = 0.016). Conclusions: Persistence, recurrence of pHPT, and reoperation rate are significantly lower after STP than LTSP in MEN1 patients. Genotype seems to be associated with the recurrence of pHPT. A mutation in exon 10 is an independent risk factor for recurrence after STP, and LTSP may not be recommended when exon 10 is mutated.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Recherche translationnelle sur le diabète (RTD) - U1190

Submission date :

2024-05-15T22:17:21Z
2024-09-18T07:18:00Z