How long should we follow patients after apparently curative parathyroidectomy?

Background Little is known about the long-term recurrence risk for primary hyperparathyroidism after immediately “curative” parathyroidectomy. This study aimed to evaluate the risk of recurrent hyperparathyroidism in the 10 years after operation. Method We retrospectively identified patients with sporadic primary hyperparathyroidism undergoing initial parathyroidectomy between November 1, 2000 and June 30, 2005. Recurrence was defined as serum calcium >10.2 mg/dL after 6 months from operation. Kaplan-Meier estimates and Cox proportional hazards were used to evaluate disease-free survival and predictors of recurrence. Results We evaluated 196 patients with a 14.8% 10-year recurrence rate. Median time to recurrence was 6.3 years (interquartile range 3.4–10.8 years), and 34.5% of all recurrences were identified >10 years after operation. There was no difference in recurrence between open and minimally invasive operation ( P = .448). Double adenomas ( P = .006), intraoperative parathyroid hormone drop 10 years after the initial operation, long-term follow-up is essential.