Duration of Parathyroid Function Recovery in Patients With Protracted Hypoparathyroidism After Total Thyroidectomy for Papillary Thyroid Carcinoma

Front Endocrinol (Lausanne). 2021 Apr 19:12:665190. doi: 10.3389/fendo.2021.665190. eCollection 2021.

Abstract

Purpose: The aim of the present study is to investigate the time to recovery of parathyroid function in patients with protracted hypoparathyroidism at 1 month after total thyroidectomy of papillary thyroid carcinoma.

Materials and methods: Adult patients who underwent total thyroidectomy for papillary thyroid cancer were included. Cases of long-term hypoparathyroidism were studied for recovery of parathyroid function during the follow-up. The duration of recovery and associated variables were recorded.

Results: Out of the 964 patients, 128 (13.28%) developed protracted hypoparathyroidism and of these, 23 (2.39%) developed permanent hypoparathyroidism and 105 (10.89%) recovered: 86 (8.92%) before 6 months, 11 (1.14%) within 6 and 12 months and 8 (0.83%) after 1 year follow-up. Variables significantly associated with the time to parathyroid function recovery were number of autotransplanted parathyroid glands (HR, 1.399; 95% CI, 1.060 - 1.846; P = 0.018), serum calcium concentration >2.07 mmol/L (Hazard ratio [HR], 1.628; 95% confidence interval [CI], 1.009 - 2.628; P = 0.046) and PTH level > 1.2 pmol/L (HR, 1.702; 95% CI, 1.083 - 2.628; P = 0.021) at 1 month postoperatively.

Conclusion: Permanent hypoparathyroidism should not be diagnosed easily by time, since up to one-fifth of the patients will experience recovery after a period of 6 months and a few patients even beyond one year. The number of autotransplanted parathyroid glands is positively associated with the time to parathyroid function recovery.

Keywords: papillary thyroid carcinoma; parathyroid function recovery; permanent hypoparathyroidism; protracted hypoparathyroidism; total thyroidectomy.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Follow-Up Studies
  • Humans
  • Hypoparathyroidism / etiology
  • Hypoparathyroidism / pathology
  • Hypoparathyroidism / therapy*
  • Male
  • Middle Aged
  • Parathyroid Glands / transplantation*
  • Prognosis
  • Recovery of Function*
  • Thyroid Cancer, Papillary / pathology
  • Thyroid Cancer, Papillary / surgery*
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / surgery*
  • Thyroidectomy / adverse effects*
  • Time Factors
  • Transplantation, Autologous