Radical Treatment Of Patients Research Articles

Radical Surgical Approach to Chronic Suppurative Osteomyelitis: Case Report

Diabetes mellitus is a systemic condition potentially related to an increased risk of progression of various infections such as chronic osteomyelitis by accelerating the inflammatory process with bone tissue necrosis and suppuration. Therefore, if there is no proper management of these infections, they can be life-threatening as they spread to deeper spaces in the head and neck. We describe the case of a 52-year-old male patient with a history of diabetes mellitus and grade III osteoarthritis who was diagnosed with chronic suppurative osteomyelitis of the mandible. He underwent a multidisciplinary surgical intervention in which he underwent a hemimandibulectomy with immediate mandibular reconstruction. The present case highlights the importance of early and radical treatment of patients with chronic suppurative osteomyelitis of the mandible and systemic comorbidities. In addition, this case presents a review of diabetes mellitus and the risk of developing odontogenic infections and complications when invading deeper spaces in the head and neck. Therefore, in this population, careful planning is required for early surgical and pharmacological treatment.

136 - Radical treatment for patients with brain only oligometastatic non-small cell lung cancer- long term survival is possible

136 - Radical treatment for patients with brain only oligometastatic non-small cell lung cancer- long term survival is possible

Programmed Cell Death Ligand 1 Expression on Immune Cells and Survival in Patients With Nonmetastatic Head and Neck Cancer

The failure or success of radical treatment in patients with head and neck squamous cell carcinoma (HNSCC) is associated with many known and unknown factors; hence, there is a search for further prognostic markers to help optimize therapeutic strategy and improve treatment outcomes. To assess the association of programmed cell death ligand 1 (PD-L1) expression on immune or tumor cells, including its composite expression on both cell types, with overall survival (OS) or specific survival. MEDLINE, Embase, PQSciTech, and HCAPlus databases were systematically searched for cohort studies focused on the prognostic role of PD-L1 expression in patients with HNSCC in curative stages of the disease. Search results generated publications from January 1, 2010, to January 6, 2023. Of 3825 publications identified, a total of 17 cohort studies in the English language met inclusion criteria of this systematic review and meta-analysis. Eligible studies reported adjusted hazard ratios (aHRs) with 95% CIs for the association of PD-L1 expression levels with OS and arbitrary specific survival. Data from studies were extracted independently by 2 researchers strictly adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines and recommendations. The risk of bias was assessed using the Quality in Prognosis Studies tool and Newcastle-Ottawa Scale. Pooled effect estimates were obtained using a random-effect or fixed-effect model based on homogeneity of studies. The primary outcome was to investigate whether there was an association between PD-L1 expression on immune or tumor cells and OS. In 17 cohort studies of the association of PD-L1 expression with survival in 3190 patients with HNSCC, high PD-L1 expression on immune cells was associated with a favorable OS (pooled aHR, 0.39; 95% CI, 0.25-0.59). There was no association between composite PD-L1 expression on immune and tumor cells and OS (pooled aHR, 0.79; 95% CI, 0.55-1.14) or between PD-L1 expressed only on tumor cells and OS (pooled aHR, 1.22; 95% CI, 0.87-1.70). A high level of PD-L1 expression on immune cells was associated with favorable specific survival (pooled aHR, 0.52; 95% CI, 0.38-0.72). There were no interactions between tumor location or type of primary treatment (ie, surgery vs radiotherapy or radiochemotherapy) and the association between PD-L1 expression and OS. This study's findings suggest that PD-L1 expression on immune cells may serve as a new prognostic biomarker in patients with HNSCC. However, future studies may be warranted to verify this potential role given the limited number of studies on this topic conducted and published to date.

Radiation therapy for brain stem tumor in children

Background. Tumors of the central nervous system occupy the first place in the structure of causes of death from malignant tumors among children. The tumors of brain stem structures account for 10 to 15% of all intracranial neoplasms in this age group. The etiology of these tumors is not completely known. Diagnosis of pathology is based on clinical manifestations and magnetic resonance imaging. Obtaining material for histological examination at this location is associated with the risk of severe neurological disorders. Despite clinical trials in search of targeted therapy, the treatment of this pathology is based on chemoradiation therapy. Purpose – to analyze the effectiveness of radiation therapy in mono-mode and in patients with the tumors of brain stem structures without intake of Temozolomide, a ccording to the results of clinical studies conducted on the basis of National Children’s Specialized Hospital «OKHMATDYT» of the Ministry of Health of Ukraine. Materials and Methods. On the basis of the National Children’s Specialized Hospital «OKHMATDYT» of the Ministry of Health of Ukraine, in the Department of Radiation Therapy of the Radiology Center during the 3-year existence, 22 people with brain stem tumor were treated on a linear electron accelerator Elekta Sinergy S. By gender: 12 boys aged 3–10 (54%), 10 girls aged 3–11 (46%). The average life expectancy of girls was longer and exceeded one year, compared with boys. The average age was 6 ± 4 years. The diagnosis in most cases was made radiologically, but 4 patients (18%) had histological confirmation. Radiation therapy was performed according to the High grade glioma protocol with total basic dose (TBD) of up to 54 Gy for 30 fractions. 2 patients received repeated radiation therapy due to the deterioration of neurological symptoms and negative dynamics on MRI. Planning of 3D-CRT, IMRT, VMAT irradiation techniques was performed on a Monaco planning system using the Monte Carlo calculation algorithm. Results. The use of radiation therapy with appropriate anti-edematous drug support, provided significant improvement in the neurological status of the child in 5–14 days from the beginning. After 4–6 weeks of control in 21 patients there was a decrease in the pathological focus compared to the original size by 17–70%. In 5 patients the tumor spread to the large hemispheres and/ or spinal cord after radiation therapy. 2 patients received repeated radiation therapy in 1 year and 1 year and 1 month after the previous one, based on the deterioration of neurological symptoms and negative dynamics on MRI. The average life expectancy was 13 months ± 7 months. It was longer for girls – more than a year, compared to boys. Conclusions. Diffuse intrinsic pontine gliomas are the leading cause of child mortality among patients with CNS tumors. Less than 10% of children live more than 2 years after diagnosis. At present, there is no method of radical treatment of patients with diffuse intrinsic point glioma. Radiation therapy still remains the main standard of treatment for DIPG, which improves the quality and duration of a child’s life.

The role of brachytherapy in the treatment of tumors of the trachea and bronchi

The original methods of the radical and palliative endobronchial and combined radiation treatment of patients with primary and relapsing cancer of trachea and bronchi and the approaches to the calculation of dosimetric radiation plans are developed and suggested. The possibility of combining endobronchial radiation therapy, distance radiation therapy and laser destructionof the tumor, is studied. The indications to endobronchial radiation therapy are formulated. The suggested method of the endobronchial and combined radiation treatment significantly extended the possibilities of organsaving treatment of patients with primarily multiple metachronous and synchronous cancer and made it possible to formulate the new approaches to the radical treatment of patients with locally spread cancer of trachea.

Potential of miRNAs in urinary extracellular vesicles for management of active surveillance in prostate cancer patients

BackgroundActive surveillance is an alternative to radical treatment for patients with low-risk prostate cancer, which could also benefit some patients with intermediate risk. We have investigated the use of miRNA in urinary extracellular vesicles to stratify these patients.MethodsNGS was performed to profile the miRNAs from small urinary extracellular vesicles in a cohort of 70 patients with prostate cancer ISUP Grade 1, 2 or 3. The most promising candidates were then analysed by RT-qPCR in a new cohort of 60 patients.ResultsNGS analysis identified nine miRNAs differentially expressed in at least one of the comparisons. The largest differences were found with miR-1290 (Grade 3 vs. 1), miR-320a-3p (Grade 3 vs. 2) and miR-155-5p (Grade 2 vs. 1). Combinations of 2–3 miRNAs were able to differentiate between two ISUP grades with an AUC 0.79–0.88. RT-qPCR analysis showed a similar trend for miR-186-5p and miR-30e-5p to separate Grade 3 from 2, and miR-320a-3p to separate Grade 2 from 1.ConclusionsUsing NGS, we have identified several miRNAs that discriminate between prostate cancer patients with ISUP Grades 1, 2 and 3. Moreover, miR-186-5p, miR-320a-3p and miR-30e-5p showed a similar behaviour in an independent cohort using an alternative analytical method. Our results show that miRNAs from urinary vesicles can be potentially useful as liquid biopsies for active surveillance.

Current capabilities in treatment of non-metastatic castration-resistant prostate cancer: effectiveness, safety, and quality of life of patients taking darolutamide

Prostate cancer is an important disease in current oncological urology. Radical treatment of patients with localized and locally advanced prostate cancer, including surgical and radiological treatments, often does not cure patients from this pathology, especially in the group with high risk of disease progression; the risk of biochemical recurrence in this patient group can be up to 40-60 %. Widespread application of radical treatment allowed to significantly increase survival of patients from this group. However, in case of biochemical recurrence, the majority of patients require longterm androgen-depriving therapy for suppression of natural testosterone level. In some of these patients during longterm castration therapy, non-metastatic castration-resistant prostate cancer develops (CRPC) in the absence of signs of radiological disease progression. Results of large randomized trials show the necessity of stratification of these patients in the group with high risk of progression considering short doubling period of prostate-specific antigen and realization of distant metastases. The main therapy concept for this patient group is use of new-generation inhibitors of androgen signal to increase time to CRPC metastases and overall life expectancy. The article presents results of large trials performed in patients with non-metastatic CRPC and characterizes the role of one of the most effective drugs, darolutamide, used for treatment in this patient cohort.

TP9.2.2Evaluating the Outcomes of anal squamous cell carcinoma (ASCC) with curative intent- a 10-year experience

Abstract Background Our 10-year experience with radical treatment of patients with ASCC. Patients and Method Data of patients with ASCC treated with curative intent were analysed between January 2011 and December 2019. Patients underwent the standard workup, treated and followed up accordingly. The outcome measures were response to radical chemoradiotherapy, recurrent disease, disease-free and overall survival. Results 117 patients were diagnosed with anal cancer. 26 ASCC patients palliatively treated, adenocarcinoma(11), melanoma(1), Paget disease(1) and carcinoid(1) were excluded. Median age of included patients was 65(38-90) years with a male to female ratio of 1:1.9. Three patients were HIV positive and 52% of the patients had AIN of varying degree of dysplasia. AJCC stages were I(16), II(18), IIIA(19), IIIB(9) and IV(15). 88.3%%(68/77) of the patients had radical chemoradiotherapy while 9 patients with tumours ≤2cm underwent wide local excision. 92.6%(63/68) of the patients treated with radical chemoradiotherapy had complete response while 7.4%(5/77) had partial response. Four patients with incomplete response underwent salvage APER. 13%(10/77) of the patients developed recurrent disease. Mean survival time was 99.82(95% CI 88.87-110.77) months with 5-year overall survival rate of 78.0%. The mean disease-free survival time was 111.82(95% CI 102.38-121;26) months. 75.3%(58/77) of the patients were alive at the end of the study with an overall mortality rate was 24.7% and disease-specific mortality was 15.6%. Conclusion ASCC responds well to radical chemoradiotherapy with favourable outcome but locoregional failure and distant metastases are still issues.

Defining oligometastatic non-small cell lung cancer: concept versus biology, a literature review.

ObjectiveIn this review, the concept of (synchronous) oligometastatic disease in patients with non-oncogene-driven non-small cell lung cancer (NSCLC) will be placed in the context of tumor biology and metastatic growth patterns. We will also provide considerations for clinical practice and future perspectives, which will ultimately lead to better patient selection and oligometastatic disease outcome.BackgroundThe treatment landscape of metastasized NSCLC has moved from “one-size fits all” to a personalized approach. Prognosis has traditionally been poor but new treatment options, such as immunotherapy and targeted therapy, brighten future perspectives. Another emerging development is the recognition of patients with so-called “oligometastatic” state of disease. Oligometastatic disease has been recognized as a distinct clinical presentation in which the tumor is stated to be early in its evolution of metastatic potential. It is suggested that this stage of disease has an indolent course, comes with a better prognosis and therefore could be considered for radical multimodality treatment.MethodsNarrative overview of the literature synthesizing the findings of literature retrieved from searches of computerized databases, hand searches, and authoritative texts.ConclusionsOligometastatic NSCLC is a broad spectrum disease, with a variable prognosis. Although the biology and behavior of “intermediate state” of metastatic disease are not fully understood, there is evidence that a subgroup of patients can benefit from local radical treatment when integrated into a multimodality regime. The consensus definition of oligometastatic NSCLC, including accurate staging, may help to uniform future trials. The preferable treatment strategy seems to sequential systemic treatment with subsequent local radical treatment in patients with a partial response or stable disease. Prognostic factors such as N-stage, number and site of distant metastases, tumor volume, performance status, age, and tumor type should be considered. The local radical treatment strategy has to be discussed in a multidisciplinary team meeting, taking into account patient characteristics and invasiveness of the procedure. However, many aspects remain to be explored and learned about the cancer biology and characteristics of intermediate state tumors.

P-217 Evaluation of the percutaneous endoscopic gastrostomy in situ rates following completion of radical treatment in patients with oropharyngeal squamous cell carcinomas: a single centre experience

P-217 Evaluation of the percutaneous endoscopic gastrostomy in situ rates following completion of radical treatment in patients with oropharyngeal squamous cell carcinomas: a single centre experience

The role of mpMRI in qualification of patients with ISUP 1 prostate cancer on biopsy to radical prostatectomy

BackgroundTo investigate the role of mpMRI and high PIRADS score as independent triggers in the qualification of patients with ISUP 1 prostate cancer on biopsy to radical prostatectomy.MethodsBetween January 2017 and June 2019, 494 laparoscopic radical prostatectomies were performed in our institution, including 203 patients (41.1%) with ISUP 1 cT1c-2c PCa on biopsy. Data regarding biopsy results, digital rectal examination, PSA, mpMRI and postoperative pathological report have been retrospectively analysed.ResultsIn 183 cases (90.1%) mpMRI has been performed at least 6 weeks after biopsy. Final pathology revealed ISUP Gleason Grade Group upgrade in 62.6% of cases. PIRADS 5, PIRADS 4 and PIRADS 3 were associated with Gleason Grade Group upgrade in 70.5%, 62.8%, 48.3% of patients on final pathology, respectively. Within PIRADS 5 group, the number of upgraded cases was statistically significant.ConclusionsPIRADS score correlates with an upgrade on final pathology and may justify shared decision of radical treatment in patients unwilling to repeated biopsies. However, the use of PIRADS 5 score as a sole indicator for prostatectomy may result in nonnegligible overtreatment rate.

New Approach to the Surgical Treatment of Cardioesophageal Cancer in the Context of the COVID-19 Pandemic (Case Report)

Background. The wide and rapid spread of the new coronavirus infection, unfortunately, makes its own adjustments in clinical practice, including in the promotion of specialized care for oncological patients. Clinical case description. The authors demonstrated an example of a successful radical treatment of adenocarcinoma of the esophageal-gastric junction, complicated by dysphagia and recurrent bleeding from the tumor. Аn integrated approach, gastrostomy, adequate correction of concomitant diseases and timely vaccination against COVID-19 made it possible to carry out a full-fledged intervention in a timely manner. Conclusions. Radical treatment of patients with gastrointestinal toncological diseases in a severe viral pandemic is possible. Emergency vaccination significantly reduces the risk of developing severe respiratory and other disorders.

DYSLIPIDEMIA IN LIVER TRANSPLANT RECIPIENTS

Liver transplant is known to be the only radical treatment for patients with end-stage liver diseases. It is known that cardiovascular diseases rank third among patients, who underwent liver transplant. Due to the current generally accepted policy of aggressive treatment of hypercholesterolemia, mortality from cardiovascular diseases has been significantly reduced in general population. Statin therapy has also demonstrated a de- creasing effect on mortality among patients with chronic liver failure. Recently published research results have shown the increasing occurrence of non-com- municable diseases among liver recipients, including diseases that determine cardiovascular mortality (arterial hypertension, chronic coronary syndrome, chronic heart failure, chronic kidney failure). This evidence demonstrates that in post-operative period doctors should do their best to identify not only traditional risk factors of acute transplant rejection, but also pay attention to cardiovascular risks and their timely treatment. Based on the data about a number of differences in the incidence of cardiovascular risk factors and on the specifics of confirmation and treatment of chronic coronary heart disease in liver transplant recipients in comparison with the general population, we believe that in transplant centers it is necessary to develop a specialized algorithm of dispensary follow-up of recipients (checklist) for adequate prevention of diseases of the circulatory system.

Rare clinical observation of primary tracheal cancer

The article describes a clinical example of primary adenoid cystic carcinoma of the trachea, characteristics of its clinical course, diagnosis and the choice of treatment. We noted the non-specificity of complaints and clinical manifestations of tracheal cancer, the period between its beginning and diagnosis, the development of severe complications in the respiratory and cardiovascular systems due to the long asymptomatic course of the disease, the need for an integrated approach by various specialists in the treatment of such a complex category of patients. An approach to the surgical treatment of tracheal cancer is described taking into account its extension to the subglottic larynx, which required laryngeal extirpation. We showed the possibility of radical treatment of patients with tracheal cancer in large medical centers with such specialists as head and neck cancer surgeons, thoracic surgeons, endoscopists, anesthesiologists and resuscitators, therapists, radiologists, and chemotherapists.

Drug-eluting bead transarterial chemoembolization is an effective downstaging option for subsequent radical treatments in patients with hepatocellular carcinoma: A cohort study

BackgroundThis study aimed to investigate the potential of drug-eluting bead transarterial chemoembolization (DEB-TACE) as downstaging therapy for subsequent radical treatment in patients with hepatocellular carcinoma (HCC). MethodsTotally, 32 patients with unresectable HCC were enrolled, then they received DEB-TACE for down-staging therapy followed by radical treatments (surgery, radiofrequency ablation or microwave ablation). The rate of successful down-staging, treatment response (after DEB-TACE and radical therapy), alpha-fetoprotein (AFP), progression-free survival (PFS) and overall survival (OS) were assessed. ResultsAfter down-staging therapy with DEB-TACE, successful down-staging rate was 59.4%. With the followed radical treatment, the complete response was 81.3%. Subsequent analysis indicated that CNLC stage (IIb vs. IIa) was an independent risk factor for successful down-staging. Furthermore, AFP level presented a declined trend throughout the time points (before DEB-TACE, after DEB-TACE, and after radical treatment). Additionally, 1-year, 2-year and 3-year accumulating PFS were 68.8%, 40.6% and 31.3%, respectively; 1-year, 2-year and 3-year accumulating OS were 84.4%, 71.9% and 53.1%, respectively. Kaplan-Meier curves exhibited that successful down-staging was correlated with longer PFS and OS, then further Cox’s regression analysis verified that successful down-staging was an independent factor for predicting increased OS but not PFS. Besides, child-Pugh stage (B vs. A), CNLC stage (IIb vs. IIa) and AFP abnormal after radical treatment were independent factors for decreased PFS or OS. ConclusionsDEB-TACE has potential as an additionally effective down-staging therapy for radical treatments, and successful down-staging treatment by DEB-TACE associates with favorable survival profiles in patients with unresectable HCC.

Bladder-conserving Approach in Radical Treatment of Patients With Bladder Cancer - A Single-institution Experience.

To evaluate our experience with radical radiotherapy and chemotherapy in patients with muscle-invasive bladder cancer. The study consisted of 27 patients treated with cisplatin-based chemoradiation (CCRT), 48 treated with radiation alone (RT), and 42 with locally advanced disease treated with neoadjuvant chemotherapy and radiation (neoCRT). The incidence of acute grade 3 or more genitourinary (GU) toxicity in the RT, CCRT and neoCRT groups was: 25%, 11% and 19%, respectively (p=0.029). The 3-year freedom from grade 2 or more GU toxicity was: 81%, 89%, 54%, respectively (p=0.36). The long-term outcomes of 3-year local control, overall survival, and disease-free survival were as follows: RT group: 74%, 61% and 55%; CCRT group: 76%, 76% and 56%; neoCRT group: 31%, 43% and 18%, respectively. The preferable bladder-conserving approach is CRT, however RT alone might also be an option for appropriately selected patients. NeoCRT for those with locally advanced tumors remain unsatisfactory; adequate selection of patients for radical treatment is of importance.

Evaluation the quality of life of patient’s with cyst maxillary sinus after endoscopical sinusotomy with different approaches

Topicality: The radical treatment for patients with cysts of the paranasal sinuses is only surgery. There are different approaches used for sinusotomy. Objective: Comparison of the impact on the quality of life of patients performing maxillofacial surgery with different options for surgical approaches. Methods and materials: 110 patients who underwent endoscopic sinus surgery for maxillary sinus cysts removing were examined. They were divided into 3 groups, according to the selected approach: 1st group – sublabial approach (35 people), 2nd group – anthrostomy through the middle nasal meatus (35 people), 3rd group – infraturbinal approach (40 people). To evaluate the quality of life of patients, we used our validated Ukrainian language version of the SNOT-22 questionnaire. Results and discussion: In the early period after maxillofacial surgery there was a significant deterioration in the quality of life of patients, which was more pronounced in groups 1 and 2 and was respectively Ʃsublab 45.3 ± 1.3 and Ʃantrostomy 42.1 ± 1.2 a in patients of group 3 it was significantly lower – Ʃinfr 21.4 ± 0.9 (p <0.05). The total score of ear/facial symptoms on the 3rd day after sublabial sinusotomy was 7.3 ± 1.9 points, which is 1.7 times higher than in the second and 6 times higher than in the 3rd group. According to rhinological symptoms, the greatest impact on the quality of life of patients was observed in patients for whom anthrostomy was chose nasal approach (12.3±1.7 points), which is 1.8 times more than in maxillary microsinusotomy and 2.3 times more than in infraturbinal approach. Conclusions: Infraturbinal approach sinusitis compared with sublabial and anthrostomy according to the SNOT-22 survey has a smaller impact on the quality of life of patients. According to the results of the SNOT 22 survey in the early postoperative period after endoscopic maxillary sinusomy with approach through the antrostomy, there is deterioration in the quality of life of patients mainly due to rhinological complaints, while with sublabial approach – due to ear/facial.

Determining the Impact of Spatial Heterogeneity on Genomic Prognostic Biomarkers for Localized Prostate Cancer

Localized prostate tumors show remarkably diverse clinical courses, with some being cured by local therapy alone, while others rapidly relapse and have a lethal course despite precision surgery or radiotherapy. Many genomic biomarkers have been developed to predict this clinical behavior, but these are confounded by the extreme spatial heterogeneity of prostate tumors: most are multifocal and harbor multiple subclonal populations. To quantify the influence of spatial heterogeneity on genomic prognostic biomarkers, we developed a case-control high-risk cohort (n = 42) using a prospective registry, risk matched by clinicopathologic prognostic indices. Half of the cohort had early biochemical recurrence (BCR; ie, ≤18 mo), while half remained without evidence of disease for at least 48 mo after radical prostatectomy. We then genomically profiled multiple tumor foci per patient, analyzing 119 total specimens. These data allowed us to validate three published genomic prognostic biomarkers and quantify their sensitivity to tumor spatial heterogeneity. Remarkably, all three biomarkers robustly predicted early BCR, and all three were robust to spatiogenomic variability. These data suggest that DNA-based genomic biomarkers can overcome intratumoral heterogeneity: single biopsies may be sufficient to estimate the risk of early BCR after radical treatment in patients with high-risk disease. Patient summaryWe investigated whether heterogeneity between tumor regions within the prostate affects the accuracy of DNA-based biomarkers predicting early relapse after prostatectomy. We observed persistent accuracy in predicting disease relapse, suggesting that spatial heterogeneity may not hinder biomarker performance.

Neoadjuvant hormonal therapy with bicalutamide 150 mg before radical treatment in patients with localized and locally advanced prostate cancer

Neoadjuvant hormonal therapy with bicalutamide 150 mg before radical treatment in patients with localized and locally advanced prostate cancer

ОТДАЛЕННЫЕ РЕЗУЛЬТАТЫ ПОЭТАПНОЙ ПАРАТИРЕОИДЭКТОМИИ

Removal of the altered parathyroid gland is the only radical method of treating primary hyperparathyreosis. Distant results of application of low-invasive parathyroidectomy under ultrasound-guided using percutaneоus laser ablation. The aim of the study was to assess the long-term results of the use of ultrasound-guided percutaneous laser ablation in patients with primary hyperparathyroidism based on the results of the main laboratory indicators. This technique implies stage-by-stage removal of the parathyroid gland in outpatientpoliclinic conditions. The study included 22 patients with primary hyperparathyroidism. All patients underwent pre-operative topical diagnosis using ultrasound method and fine-needle aspiration biopsy with hormonal examination in aspiration material and laboratory diagnosis in pre and post-operative period with study of parathyroid hormone and ionized calcium levels. In 86%, the main laboratory indicators, having decreased to reference values 1 month after the operation, remained at the same level and after 5 years. In 14%, persistence and recurrence of the disease were revealed. The carried-out analysis of results of laboratory diagnostics confirms long-term, long decrease in the key laboratory indicators. The detected effectiveness (in 86%) in the distant period allows to speak about viability of this variant of parathyroidectomy and possibility of its application as radical treatment in patients with primary hyperparathyroidism. A prerequisite for obtaining the desired result is patient selection and parathyroidectomy performed by a specially trained surgeon and ultrasonic diagnostic doctor.