Extent of Surgical Resection and Predictors of Outcomes in MEN1-related Hyperparathyroidism: A Systematic Review and Meta-analysis
Authors' conclusion
Conservative surgery reduces hypoparathyroidism but increases recurrence. Personalized surgical strategies are essential in MEN1-related PHPT.
Study context
- Population
- Adult MEN1-related primary hyperparathyroidism (PHPT) patients undergoing parathyroidectomy
- Participants
- 915 patients13 studies
- Comparison
- Less-than-subtotal vs subtotal vs total parathyroidectomy with autotransplantation in MEN1-related PHPT
- Outcome
- Recurrence and permanent hypoparathyroidism
Methodological detailsrandom-effects models, meta-regression, PRISMA, MEDLINE, PubMed, Embase.com, LILACS and CENTRAL searched from inception to April 2025, Two reviewers independently extracted data and assessed study quality
- Random-effects models
- Meta-regression
- PRISMA
- MEDLINE, PubMed, Embase.com, LILACS and CENTRAL searched from inception to April 2025
- Two reviewers independently extracted data and assessed study quality
Pooled result
As reported in the abstract
Recurrence
Relative risk (95% CI)
<STPTvs STPThigher recurrence with <STPT
1.26(1.16–1.36)
<STPTvs PTXhigher recurrence with <STPT
1.35(1.22–1.49)
STPTvs PTXslightly higher recurrence with STPT
1.12(1.02–1.24)
<STPTvs STPT/PTXhigher recurrence with <STPT
1.23(1.03–1.46)
Further pooled results
Preoperative PTH, calcium, phosphorus as predictors of outcomes
- No significant associations of preoperative PTH, calcium or phosphorus with outcomes
- Meta-regression
Safety
| Outcome | RR (95% CI) | |
|---|---|---|
| Hypoparathyroidism<STPTvs STPT | 0.90 (0.82–0.98) | |
| Hypoparathyroidism<STPTvs PTX | 0.76 (0.63–0.90) | |
| Hypoparathyroidism<STPTvs STPT/PTX | 0.86 (0.78–0.96) | |
| 0.512Relative risk (log scale) |
Original publication
Extent of Surgical Resection and Predictors of Outcomes in MEN1-related Hyperparathyroidism: A Systematic Review and Meta-analysis. J Clin Endocrinol Metab. Published 2 September 2025. doi:10.
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