{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:04:13Z","timestamp":1789535053018,"version":"build-2803163510"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the short-term biochemical efficacy and safety of microwave ablation (MWA) and parathyroidectomy (PTX) in patients with primary hyperparathyroidism (PHPT), and to identify independent predictors of treatment failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 173 consecutive patients with PHPT treated with MWA (n = 46) or PTX (n = 127) between January 2019 and January 2025. Covariate-balancing propensity score\u2013derived inverse probability of treatment weighting (CBPS-IPTW) was used to balance baseline characteristics. Longitudinal changes in parathyroid hormone (PTH), calcium, and phosphorus were assessed using IPTW-weighted linear mixed-effects models, whereas biochemical treatment failure and safety outcomes were compared using weighted logistic regression with robust standard errors. IPTW-weighted Kaplan\u2013Meier and Cox analyses were exploratory, and factors associated with treatment failure were evaluated using Firth penalized logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After weighting, all covariates were well balanced, with absolute standardized mean differences &amp;lt;0.01. Both treatments produced substantial biochemical improvement. A significant treatment-by-time interaction was observed for PTH (P &amp;lt; 0.001), whereas calcium and phosphorus trajectories did not differ significantly. The weighted risks of treatment failure were 23.8% after PTX and 35.9% after MWA [odds ratio (OR), 1.80; 95% confidence interval (CI), 0.74\u20134.39], with an absolute risk difference of 12.1 percentage points (95% CI, \u22127.3 to 31.6). Exploratory Cox analysis showed no significant difference in documented treatment failure (hazard ratio, 1.73; 95% CI, 0.82\u20133.64). Weighted hypocalcemia risks were 9.2% and 15.5%, respectively (OR, 1.81; 95% CI, 0.50\u20136.56). Each doubling of baseline PTH was associated with approximately twofold higher odds of treatment failure (OR, 2.02; 95% CI, 1.39\u20134.09).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both MWA and PTX produced substantial short-term biochemical improvement. No significant difference in 6-month treatment failure was detected after CBPS-IPTW adjustment; however, wide confidence intervals precluded conclusions of equivalence or non-inferiority. Baseline PTH may help identify patients at increased risk of incomplete biochemical response, and MWA may be considered for carefully selected patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1921824","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:30:02Z","timestamp":1789533002000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Short-term biochemical outcomes after microwave ablation versus parathyroidectomy for primary hyperparathyroidism: an IPTW analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Le","family":"Yin","sequence":"first","affiliation":[{"name":"The Affiliated Hospital of Qingdao University","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Luo","sequence":"additional","affiliation":[{"name":"The Affiliated Hospital of Qingdao University","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yalin","family":"Chai","sequence":"additional","affiliation":[{"name":"The Affiliated Hospital of Qingdao University","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijie","family":"Sun","sequence":"additional","affiliation":[{"name":"The Affiliated Hospital of Qingdao University","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Congjuan","family":"Luo","sequence":"additional","affiliation":[{"name":"The Affiliated Hospital of Qingdao University","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31430-7","article-title":"Hyperparathyroidism","volume":"391","author":"Bilezikian","year":"2018","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcr225","article-title":"Diagnosis and management of primary hyperparathyroidism in Europe","volume":"105","author":"Langdahl","year":"2012","journal-title":"QJM"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.4665","article-title":"Epidemiology, pathophysiology, and genetics of primary hyperparathyroidism","volume":"37","author":"Minisola","year":"2022","journal-title":"J Bone Miner Res"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.4677","article-title":"Evaluation and management of primary hyperparathyroidism: Summary statement and guidelines from the fifth international workshop","volume":"37","author":"Bilezikian","year":"2022","journal-title":"J Bone Miner Res"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.4679","article-title":"Classical and nonclassical manifestations of primary hyperparathyroidism","volume":"37","author":"El-Hajj Fuleihan","year":"2022","journal-title":"J Bone Miner Res"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2017.104","article-title":"Primary hyperparathyroidism","volume":"14","author":"Walker","year":"2018","journal-title":"Nat Rev Endocrinol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgag162","article-title":"Increasing incidence and prevalence of biochemically confirmed primary hyperparathyroidism in Stockholm, 2006-2020","volume":"111","author":"Thorsteinsson","year":"2026","journal-title":"J Clin Endocrinol Metab"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.0538","article-title":"Diagnosis and management of primary hyperparathyroidism","volume":"323","author":"Zhu","year":"2020","journal-title":"JAMA"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD013035.pub2","article-title":"Parathyroidectomy for adults with primary hyperparathyroidism","volume":"3","author":"Pappachan","year":"2023","journal-title":"Cochrane Database Syst Rev"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00198-016-3716-2","article-title":"Primary hyperparathyroidism: Review and recommendations on evaluation, diagnosis, and management. 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