{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:23:26Z","timestamp":1791267806210,"version":"4.1.0"},"reference-count":36,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T00:00:00Z","timestamp":1756771200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Primary hyperparathyroidism (PHPT) is the earliest and most frequent manifestation of multiple endocrine neoplasia type 1 (MEN1). The optimal surgical extent remains controversial due to the tradeoff between recurrence and permanent hypoparathyroidism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate outcomes of different surgical approaches in MEN1-related PHPT and assess preoperative biochemical predictors through systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>MEDLINE, PubMed, Embase.com, LILACS, and CENTRAL were searched from inception to April 2025, following PRISMA guidelines (PROSPERO: CRD420251027970).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Selection<\/jats:title>\n                    <jats:p>We included studies on adult MEN1-related PHPT patients undergoing parathyroidectomy with reported recurrence, hypoparathyroidism, and preoperative biochemical data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Extraction<\/jats:title>\n                    <jats:p>Two reviewers independently extracted data and assessed study quality. Random-effects models were used to pool risk ratios (RR) with 95% confidence intervals (CI). Meta-regression evaluated associations with preoperative PTH, calcium, and phosphorus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Synthesis<\/jats:title>\n                    <jats:p>Thirteen studies (915 patients) were included. Less-than-subtotal parathyroidectomy (&amp;lt;STPT) had higher recurrence than subtotal parathyroidectomy (STPT) (RR = 1.26; 95% CI: 1.16-1.36) and total parathyroidectomy with autotransplantation (PTX) (RR = 1.35; 95% CI: 1.22-1.49). STPT showed slightly higher recurrence than PTX (RR = 1.12; 95% CI: 1.02-1.24). &amp;lt;STPT had lower hypoparathyroidism than STPT (RR = 0.90; 95% CI: 0.82-0.98) and PTX (RR = 0.76; 95% CI: 0.63-0.90). Grouping &amp;lt; STPT vs STPT\/PTX confirmed higher recurrence (RR = 1.23; 95% CI: 1.03-1.46) and lower hypoparathyroidism (RR = 0.86; 95% CI: 0.78-0.96). No significant associations were found for preoperative PTH, calcium, or phosphorus with outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Conservative surgery reduces hypoparathyroidism but increases recurrence. Personalized surgical strategies are essential in MEN1-related PHPT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf492","type":"journal-article","created":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T11:56:53Z","timestamp":1756555013000},"page":"291-301","source":"Crossref","is-referenced-by-count":2,"title":["Extent of Surgical Resection and Predictors of Outcomes in MEN1-related Hyperparathyroidism: A Systematic Review and Meta-analysis"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7315-6079","authenticated-orcid":false,"given":"Wellington","family":"Alves Filho","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery, Faculty of Medicine, Hospital Universit\u00e1rio Walter Cantidio, Federal University of Cear\u00e1 , Fortaleza 60430-372 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Janu\u00e1rio Farias Pereira","family":"Filho","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Faculty of Medicine, Hospital Universit\u00e1rio Walter Cantidio, Federal University of Cear\u00e1 , Fortaleza 60430-372 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria Maria Caland","family":"Morais","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Faculty of Medicine, Hospital Universit\u00e1rio Walter Cantidio, Federal University of Cear\u00e1 , Fortaleza 60430-372 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Balbino","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Faculty of Medicine, Hospital Universit\u00e1rio Walter Cantidio, Federal University of Cear\u00e1 , Fortaleza 60430-372 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1988-8543","authenticated-orcid":false,"given":"Mar\u00edlia D\u2019Elboux Guimar\u00e3es","family":"Brescia","sequence":"additional","affiliation":[{"name":"Parathyroid Unit\u2014LIM-28, Laborat\u00f3rio de Cirurgia de Cabe\u00e7a e Pesco\u00e7o, Division of Head and Neck Surgery, Department of Surgery, Hospital das Clinicas, University of S\u00e3o Paulo School of Medicine , S\u00e3o Paulo 01246-903 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5749-2363","authenticated-orcid":false,"given":"Fabio Luiz de Menezes","family":"Montenegro","sequence":"additional","affiliation":[{"name":"Parathyroid Unit\u2014LIM-28, Laborat\u00f3rio de Cirurgia de Cabe\u00e7a e Pesco\u00e7o, Division of Head and Neck Surgery, Department of Surgery, Hospital das Clinicas, University of S\u00e3o Paulo School of Medicine , S\u00e3o Paulo 01246-903 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7332-9841","authenticated-orcid":false,"given":"Catarina Brasil","family":"d\u2019Alva","sequence":"additional","affiliation":[{"name":"Department of Clinical Endocrinology and Diabetes, Faculty of Medicine, Federal University of Cear\u00e1 , Fortaleza 60430-372 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1876-6410","authenticated-orcid":false,"given":"Ana Rosa Pinto","family":"Quidute","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology, Drug Research and Development Center, Faculty of Medicine, Federal University of Cear\u00e1 , Fortaleza 60430-372 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9186-4303","authenticated-orcid":false,"given":"Marcio 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