Ultrasound‐Guided Radiofrequency Ablation for the Treatment of Primary Hyperparathyroidism in Elderly Patients

ABSTRACT Aim This study aimed to assess the efficacy and safety of ultrasound‐guided radiofrequency ablation (RFA) in elderly patients with primary hyperparathyroidism (PHPT). Methods This retrospective cohort study included patients aged ≥ 60 years with PHPT who underwent ultrasound‐guided RFA at a single center between May 2021 and May 2025. A total of 36 patients were analyzed. Laboratory parameters, including serum calcium and intact parathyroid hormone (iPTH), were assessed before and after the procedure. All patients were followed for at least 6 months. Cure was defined as normalization of both serum calcium and iPTH levels during follow‐up. Procedural outcomes, complications, and factors associated with treatment response were evaluated. Results The mean age of the cohort was 70.4 (±8.69) years. After a single RFA session, 28 of 36 patients achieved a cure. When repeat procedures were included, the overall cure rate increased to 83.3% (30/36). The key procedure‐related adverse events were postoperative mild pain and hoarseness. Hoarseness was transient in most cases; permanent hoarseness occurred in one patient. No major life‐threatening complications were observed. Baseline characteristics did not differ significantly between cured and non‐cured patients. Patients who developed hoarseness were older and had lower baseline magnesium levels than those without hoarseness. Conclusions Ultrasound‐guided RFA appears to be an effective and safe minimally invasive treatment option for selected elderly patients with PHPT, achieving acceptable cure rates with a favorable safety profile. RFA may represent a valuable alternative for elderly or frail patients who are at increased surgical risk. Prospective studies with larger cohorts and longer follow‐up are warranted to confirm these findings.