Recovery of parathyroid function in patients with thyroid cancer treated by total thyroidectomy: An analysis of 685 patients with hypoparathyroidism at discharge of surgery
| Autor: | Juan J. Díez, Elena Navarro, Amelia Oleaga, Ana Megia, Manel Sahún de la Vega, Piedad Santiago-Fernández, Laura Manjón, Begoña Pérez-Corral, Cristina Álvarez-Escolá, Emma Anda, Miguel Paja, Ana R Romero-Lluch, María Picallo, Julia Sastre, José Carlos Fernández-García, Eva Sanz, Concepción Blanco-Carrera, Carles Zafon, Beatriz Lecumberri, Cecilia Sánchez-Ragnarsson, Pedro Iglesias, Juan C. Galofré, Sergio Donnay, Orosia Bandrés, Marcel Sambo, Gloria Baena-Nieto |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Hypoparathyroidism Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Parathyroid Glands 03 medical and health sciences 0302 clinical medicine Endocrinology Postoperative Complications medicine Humans In patient Thyroid Neoplasms Lymph node Thyroid cancer Survival analysis Retrospective Studies Total thyroidectomy Surgical team Nutrition and Dietetics business.industry Proportional hazards model medicine.disease Patient Discharge Surgery medicine.anatomical_structure Parathyroid Hormone 030220 oncology & carcinogenesis Lymphatic Metastasis Thyroidectomy Calcium business |
| Zdroj: | Endocrinología, Diabetes y Nutrición (English ed.). 68:398-407 |
| ISSN: | 2530-0180 |
| DOI: | 10.1016/j.endien.2021.10.009 |
| Popis: | We aimed to study the predictive factors for recovery of parathyroid function in hypoparathyroid patients after total thyroidectomy for thyroid cancer.We designed a retrospective, multicentre and nation-wide analysis of patients with total thyroidectomy who were seen in twenty endocrinology departments from January to March 2018. We selected patients with histologically proven thyroid cancer and retrieved information related to surgical procedure and thyroid cancer features. Survival analysis and Cox regression analysis were used to study the relationship between these variables and the recovery of parathyroid function.From 685 patients with hypoparathyroidism at discharge of surgery, 495 (72.3%) recovered parathyroid function over time. Kaplan-Meier analysis showed that this recovery was significantly related to the presence of specialized surgical team (P0.001), identification of parathyroid glands at surgery (P0.001), papillary histopathology (P=0.040), and higher levels of postoperative calcium (Ca) (P0.001) and parathyroid hormone (PTH) (P0.001). Subjects with gross extrathyroidal extension (P=0.040), lymph node metastases (P=0.004), and surgical re-intervention after initial surgery (P=0.024) exhibited a significant risk of persistence of hypoparathyroidism. Multivariate Cox regression analysis showed that the significant and independent factors for recovery of parathyroid function were postoperative concentrations of Ca (P=0.038) and PTH (P=0.049). The presence of lymph node metastases was a negative predictor of recuperation of parathyroid function (P=0.042) in this analysis.In patients with thyroid cancer, recovery of parathyroid function after total thyroidectomy was directly related to postoperative Ca and PTH concentrations, and inversely related to lymph node metastases. |
| Databáze: | OpenAIRE |
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