Omission of Intact Parathyroid Hormone Testing During Surgery in Treating Patients With Primary Hyperparathyroidism

Roswell Park Comprehensive Cancer Center

Status

Completed

Conditions

Primary Hyperparathyroidism

Parathyroid Gland Adenoma

Treatments

Procedure: Parathyroidectomy

Other: Laboratory Biomarker Analysis

Study type

Interventional

Funder types

Other

Identifiers

NCT03011736

I 274915 (Other Identifier)

NCI-2016-01974 (Registry Identifier)

Details and patient eligibility

About

This clinical trial studies the omission of intact parathyroid hormone testing during surgery in treating patients with primary hyperparathyroidism. Omission of intact parathyroid hormone testing during parathyroid gland removal may help patients with primary hyperparathyroidism to decrease their time under anesthesia, and decrease the overall time and cost of surgery.

Full description

PRIMARY OBJECTIVES:

I. Determine the non-inferiority of omission of parathyroid hormone (PTH) in patients who meet the biochemical and radiological criteria compared to current standard of care (i.e. use of intraoperative parathyroid hormone testing).

SECONDARY OBJECTIVES:

I. Cost-analysis to determine savings of omission of intraoperative PTH testing.

OUTLINE:

Patients undergo standard minimally invasive parathyroidectomy without PTH testing during surgery.

After completion of study, patients are followed up at 2 weeks.

Enrollment

6 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Positive 4 dimensional computed tomography (4D CT) for single gland (adenoma) primary hyperparathyroidism
Preoperative serum calcium levels >= 10.9 mg/dL
Preoperative parathyroid hormone (PTH) elevated beyond normal range or inappropriately high for associated calcium level
Patient has no history of prior neck surgery or external radiation to neck for malignant conditions
Have an Eastern Cooperative Oncology Group (ECOG) performance status of =< 2
Subject or legal representative must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent form prior to receiving any study related procedure

Exclusion criteria

Patient has recurrent hyperparathyroidism
4D CT positive for multiple gland disease
Patient has inability to tolerate 4D CT scan (for example; contrast intravenous (IV) allergy, claustrophobia, renal disease)
Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
Pregnant or nursing female subjects; may be determined in the preoperative evaluation
Unwilling or unable to follow protocol requirements
Any condition which in the investigator's opinion deems the subject an unsuitable candidate to undergo observational study (may also include preoperative testing results including electrocardiography [EKG], chest x-ray, or pulmonary function tests that preclude a wide excision in the operating room)