Impact of parathyroidectomy on quality of life in multiple endocrine neoplasia type 1

Autor(es)

Brescia, Marilia D'Elboux Guimaraes ; Rodrigues, Karine Candido ; d'Alessandro, Andre Fernandes ; Alves Filho, Wellington ; van der Plas, Willemijn Y. ; Kruijff, Schelto ; Arap, Sergio Samir ; Toledo, Sergio Pereira de Almeida ; Montenegro, Fabio Luiz de Menezes ; Lourenco, Delmar Muniz

• Tipo de documento: Artigo Científico
• Fonte: ENDOCRINE CONNECTIONS; v. 11, n. 6, p. 13-pg., 2022-06-01.

Resumo

Background: Potential influences of parathyroidectomy (PTx) on the quality of life (QoL) in multiple endocrine neoplasia type 1-related primary hyperparathyroidism (HPT/MEN1) are unknown. Method: Short Form 36 Health Survey Questionnaire was prospectively applied to 30 HPT/MEN1 patients submitted to PTx (20, subtotal; 10, total with autograft) before, 6 and 12 months after surgery. Parameters that were analyzed included QoL, age, HPT-related symptoms, general pain, comorbidities, biochemical/hormonal response, PTx type and parathyroid volume. Results: Asymptomatic patients were younger (30 vs 38 years; P = 0.04) and presented higher QoL scores than symptomatic ones: Physical Component Summary score (PCS) 92.5 vs 61.2, P = 0.0051; Mental Component Summary score (MCS) 82.0 vs 56.0, P = 0.04. In both groups, QoL remained stable 1 year after PTx, independently of the number of comorbidities. Preoperative general pain was negatively correlated with PCS (r = -0.60, P = 0.0004) and MCS (r = -0.57, P = 0.0009). Also, moderate/intense pain was progressively (6/12 months) more frequent in cases developing hypoparathyroidism. The PTx type and hypoparathyroidism did not affect the QoL at 12 months although remnant parathyroid tissue volume did have a positive correlation (P = 0.0490; r = 0.3625) to PCS 12 months after surgery. Patients with one to two comorbidities had as pre-PTx PCS (P = 0.0015) as 12 months and post-PTx PCS (P = 0.0031) and MCS (P = 0.0365) better than patients with three to four comorbidities. Conclusion: A variable QoL profile was underscored in HPT/MEN1 reflecting multiple factors associated with this complex disorder as comorbidities, advanced age at PTx and presence of preoperative symptoms or of general pain perception. Our data encourage the early indication of PTx in HPT/MEN1 by providing known metabolic benefits to target organs and avoiding potential negative impact on QoL. (AU)

• Processo FAPESP: 16/25594-9 - Impacto das alterações histológicas, moleculares e genéticas no tratamento cirúrgico e na evolução clínica do paciente com hiperparatireoidismo primário relacionado à neoplasia endócrina múltipla do tipo 1
• Beneficiário: Fábio Luiz de Menezes Montenegro
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 15/25444-4 - Visita do prof. Dr. Stephen J. Marx ao Brasil colaborando com projetos de pesquisa translacionais em neoplasias endócrinas hereditárias: uma interação científica entre a Universidade de São Paulo (USP) e o National Institute of Health (NIH)
• Beneficiário: Delmar Muniz Lourenço Jr
• Modalidade de apoio: Auxílio à Pesquisa - Pesquisador Visitante - Internacional
• Processo FAPESP: 13/19810-2 - Avaliação da eficácia do método de sequenciamento de nova geração na análise dos genes MEN1, CDKN2B/p15, CDKN2C/p18 CDKN1A/p21, CDKN1B/p27Kip1 e AIP em pacientes com neoplasia endócrina múltipla tipo 1 (MEN1)
• Beneficiário: Delmar Muniz Lourenço Jr
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 16/07504-2 - Avaliação de painéis gênicos baseados em sequenciamento de nova geração aplicados ao diagnóstico diferencial de neoplasia endócrina tipo 1 e na análise de correlações genótipo-fenótipo.
• Beneficiário: Delmar Muniz Lourenço Jr
• Modalidade de apoio: Auxílio à Pesquisa - Regular