Risk factors influencing cure of ultrasound-guided microwave ablation for primary hyperparathyroidism

Objective To evaluate the potential risk factors influencing cure rate of ultrasound-guided microwave ablation (MWA) for primary hyperparathyroidism (PHPT). Materials and methods Seventy five patients (25 males and 50 females; mean age, 56.80 +/- 12.34; age range, 26-85) with PHPT undergoing MWA under ultrasound guidance were enrolled between May 2017 and December 2020. The cure rate and complications were evaluated after treatment. The potential factors influencing cure rate of ultrasound-guided MWA for PHPT were analyzed by univariate and multivariate binary logistic regression. Results Fifty six of 75 patients had normal PTH and serum calcium levels after at least 6 months after one session MWA, and the cure rate was 74.7% (56/75). 6 uncured patients received the second session MWA during follow-up, and the cure rate achieved 81.3% (61/75) after the second session MWA. Voice changes occurred in 4 patients (5.33%) and recovered within 3 months after ablation without special treatment. Nodule volume was the independent risk factor associated with cure in PHPT patients undergoing MWA, whether after one session (p = 0.0224; odds ratio, 0.67) or the second session MWA (p = 0.0408; odds ratio, 0.74). The cutoff value for nodule volume in predicting the cure was 0.96 cm(3) (one session: sensitivity, 76.8%; specificity, 73.7%; the second session: sensitivity, 72.1%; specificity, 71.4%). Conclusion In conclusion, parathyroid nodule volume was the independent risk factor associated with cure in PHPT patients undergoing MWA.