Facing thyroid troubles as you age? It's a concern many older adults grapple with, but there's promising news: new research suggests a less invasive path to healing. A recent study published in Radiology sheds light on microwave and radiofrequency ablation as safe and effective alternatives to surgery for older patients dealing with hyperparathyroidism.
This study, involving 153 participants with an average age of 63, revealed impressive cure rates and minimal complications over a two-year follow-up period. Lead author Dr. Luxin Zhang and his team at the Medical School of the Chinese People’s Liberation Army in Beijing highlighted that these findings stand in stark contrast to the higher complication rates often associated with traditional parathyroidectomy in older adults. This makes microwave ablation (MWA) and radiofrequency ablation (RFA) an appealing option for those who are frail or have other reasons to avoid surgery.
But here's where it gets controversial...
Primary and secondary hyperparathyroidism are endocrine disorders that cause elevated parathyroid hormone (PTH) levels. This can increase the risk of osteoporosis, fractures, and even severe cardiovascular issues. While surgery, or parathyroidectomy, is a common treatment, it carries risks, particularly for older patients. These can include respiratory complications, cardiovascular events after surgery, delirium, and phlebitis.
MWA and RFA, on the other hand, are minimally invasive, ultrasound-guided procedures. They can be performed under local anesthesia, resulting in less trauma, quicker recovery, and fewer complications. However, until now, there hasn't been much research focusing on older patients.
To address this, the researchers examined outcomes in 153 patients over 55 years old with either primary hyperparathyroidism (PHPT) or secondary hyperparathyroidism (SHPT). These patients underwent MWA or RFA between September 2017 and March 2022.
For PHPT, the primary goal was the cure rate, defined as the proportion of patients who maintained normal PTH serum and calcium levels for at least six months. For SHPT, the goal was the proportion of patients who maintained PTH levels below 585 ng/L for at least six months. Complications were assessed over a 24-month follow-up.
The results? In PHPT patients, 80% (61 out of 76) were cured, with similar rates between MWA (78%, or 42 out of 54) and RFA (86%, or 19 out of 22). In SHPT patients, the PTH achievement rate was 90% (69 out of 77), again with comparable rates between MWA (92%, or 36 out of 39) and RFA (87%, or 33 out of 38).
Complications were generally minor and temporary. The study also found that pre-procedure PTH level was a factor in treatment failure for both PHPT and SHPT patients.
The researchers concluded that thermal ablation is a viable, less invasive alternative, especially for patients who aren't ideal candidates for surgery.
And this is the part most people miss...
The study does acknowledge its limitations, including the sample size. They suggest that larger, more comprehensive studies are needed.
What do you think? Are you surprised by these findings? Do you have any experience with these procedures or thyroid disorders in general? Share your thoughts in the comments below!
