Long-Term Impact of Genotype and Surgery in MEN1 Hyperparathyroidism

The study investigated the impact of genotype and surgical approach on long-term postoperative outcomes in patients with primary hyperparathyroidism and multiple endocrine neoplasia type 1 (MEN1). Findings showed that patients with protein-truncating germline pathogenic variants in specific exons of the MEN1 gene had aggressive pancreatic neuroendocrine tumors and earlier onset of primary hyperparathyroidism. The choice of surgical approach also affected disease-free survival, with subtotal parathyroidectomy associated with better outcomes compared to total parathyroidectomy. It is recommended to exercise caution when opting for subtotal parathyroidectomy in patients with specific MEN1 variants.