Table 1_Short-term biochemical outcomes after microwave ablation versus parathyroidectomy for primary hyperparathyroidism: an IPTW analysis.docx

Both treatments produced substantial biochemical improvement. A significant treatment-by-time interaction was observed for PTH (P < 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), 0.74–4.39], with an absolute risk difference of 12.1 percentage points (95% CI, −7.3 to 31.6).

Exploratory Cox analysis showed no significant difference in documented treatment failure (hazard ratio, 1.73; 95% CI, 0.82–3.64). Weighted hypocalcemia risks were 9.2% and 15.5%, respectively (OR, 1.81; 95% CI, 0.50–6.56). Each doubling of baseline PTH was associated with approximately twofold higher odds of treatment failure (OR, 2.02; 95% CI, 1.39–4.09).</p>Conclusion<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.</p>