Parathyroidectomy for primary hyperparathyroidism: effect on quality of life after 3 years – a prospective cohort study

Abstract

Background: The impact of parathyroidectomy (PTX) for primary hyperparathyroidism (PHPT) on long-term quality of life (QoL) remains controversial. The study evaluated QoL changes 1 and 3 years after PTX. Materials and Methods: Patients undergoing PTX for PHPT between 2016 and 2022 (n=329) were enrolled in this monocentric, prospective cohort study. QoL was evaluated using the SF-36 questionnaire before, 1 year, and 3 years after PTX and compared with an age-matched and sex-matched French reference population. Only patients with 1-year and 3-year follow-up and complete evaluation (serum calcium, phosphorus, parathyroid hormone) were included. Results: A total of 159 patients were included (mean age: 62.6±12.7 years, 79.2% females). Mean serum calcium (2.66±0.20 mmol/l) and median parathyroid hormone (96.4 [76.9−126.4] pg/ml) levels improved significantly after PTX. Before surgery, PHPT patients had impaired physical (44.6±8.9 vs. 47.6±6.8 in the reference population, P<0.001) and mental (42.3±10.9 vs. 48.9±6.8, P<0.001) component scores. The mean physical component score increased significantly at 1 and 3 years and was no longer different from the reference population (ratio: 0.94±0.15 preoperatively vs. 0.99±0.15 at 3 years, P<0.01). The mean mental component score increased significantly at 1 and 3 years, but remained significantly lower than the reference population. Before surgery, a lower physical component score and younger age were significantly associated with a 3-year physical component score increase on multiple linear regression analysis. Conclusion: A significant improvement in QoL is associated with PTX for PHPT at 1 year and is sustained for at least 3 years after surgery.