Primary hyperparathyroidism: do perioperative biochemical variables correlate with parathyroid adenoma weight or volume?
OBJECTIVE
To investigate the relationship between clinical variables and biochemical markers of calcium homeostasis and parathyroid adenoma size, in patients undergoing surgery for primary hyperparathyroidism. To determine the potential clinical utility of the findings in preoperative planning and prediction of postoperative hypocalcaemia.


METHODS
Retrospective data analysis.


METHODS
Ninety-two patients treated surgically for primary hyperparathyroidism caused by a solitary parathyroid adenoma between 1996 and 2006.


METHODS
Complete data was obtained for 77 participants including patient demographics, perioperative calcium, parathyroid hormone and phosphate levels, adenoma weight and histological dimensions. Multiple and binary logistic regression analyses were used to investigate the relationship between clinical and biochemical variables and adenoma weight and volume. Similar analysis was used to identify predictors of postoperative hypocalcaemia.


METHODS
University Teaching Hospital Otolaryngology Department.


RESULTS
The mean age at presentation was 59 years. The mean preoperative calcium and PTH levels were 2.86 +/- 0.2 mmol/L and 17.2 +/- 12.3 ng/L, respectively, falling to 2.3 +/- 0.01 and 4.1 +/- 2.7 postoperatively. The mean adenoma weight was 1.71 +/- 1.41 g. No correlation existed between clinical variables and preoperative biochemical markers of calcium homeostasis and adenoma weight or volume. There was a weak correlation between the preoperative to postoperative change in calcium and PTH levels {[deltaCa(2)+] vs. [deltaPTH]} (r = 0.24; P < 0.05) but no predictors of postoperative hypocalcaemia could be identified.


CONCLUSIONS
Biochemical parameters will not accurately predict the size of a parathyroid adenoma. The size of a parathyroid adenoma does not correlate with postoperative calcium levels and is therefore not useful as a predictor of postoperative hypocalcaemia.
Randhawa
P S
PS
Department of Otolaryngology, Royal Free Hospital, London, UK.
Mace
A D
AD
Nouraei
S A R
SA
Stearns
M P
MP
D000236:Adenoma / Q000150:complications / Q000378:metabolism* / Q000473:pathology* / Q000601:surgery; D014408:Biomarkers, Tumor / Q000097:blood*; D002118:Calcium / Q000097:blood*; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000209:etiology / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D010282:Parathyroid Neoplasms / Q000150:complications / Q000378:metabolism* / Q000473:pathology* / Q000601:surgery; D016105:Parathyroidectomy; D011237:Predictive Value of Tests; D012189:Retrospective Studies
D014408:Biomarkers, Tumor; D010281:Parathyroid Hormone; D002118:Calcium