Surgery for primary hyperparathyroidism in Germany, Switzerland, and Austria: an analysis of data from the EUROCRINE registry

• Published in: Langenbeck's archives of surgery Vol. 408; no. 1; p. 150
• Main Authors: Hargitai, L., Clerici, T., Musholt, T. J., Riss, P.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 13-04-2023
• Subjects: Abdominal Surgery; Austria; Cardiac Surgery; General Surgery; Germany; Humans; Hyperparathyroidism, Primary - surgery; Medicine; Medicine & Public Health; Parathyroid Hormone; Parathyroidectomy - methods; Positron Emission Tomography Computed Tomography - adverse effects; Switzerland; Thoracic Surgery; Traumatic Surgery; Vascular Surgery; Switzerland; Austria; Germany; Primary hyperparathyroidism; Intraoperative monitoring; Parathyroid hormone; Surgery; EUROCRINE
• ISSN: 1435-2451; 1435-2443; 1435-2451
• DOI: 10.1007/s00423-023-02819-2

Purpose
EUROCRINE is an endocrine surgical register documenting diagnostic processes, indication for surgical treatment, surgical procedures, and outcomes. The purpose was to analyse data for PHPT in German speaking countries regarding differences in clinical presentation, diagnostic workup, and treatment.
Methods
All operations for PHPT performed from 07/2015 to 12/2019 were analysed.
Results
Three thousand two hundred ninety-one patients in Germany (9 centres; 1762 patients), Switzerland (16 centres; 971 patients) and Austria (5 centres; 558 patients) were analysed. Hereditary disease was seen in 36 patients in Germany, 16 patients in Switzerland and 8 patients in Austria. In sporadic disease before primary operation, PET-CT showed the highest sensitivity in all countries. In re-operations, CT and PET-CT achieved the highest sensitivities. The highest sensitivity of IOPTH was seen in Austria (98.1%), followed by Germany (96.4%) and Switzerland (91.3%). Operation methods and mean operative time reached statistical significance (
p
<0.05). Complication rates are low. Overall, 656 (19.9%) patients were asymptomatic; the remainder showed bone manifestations, kidney stones, fatigue and/or neuropsychiatric symptoms.
Conclusion
Early postoperative normocalcaemia ranged between 96.8 and 97.1%. Complication rates are low. PET-CT had the highest sensitivity in all three countries in patients undergoing primary operation as well as in Switzerland and Austria in patients undergoing re-operation. PET-CT could be considered a first-line preoperative imaging modality in patients with inconclusive ultrasound examination. The EUROCRINE registry is a beneficial and comprehensive data source for outcome analysis of endocrine procedures on a supranational level.