Decision-making in primary hyperparathyroidism in older patients: surgical or conservative management?

While management is well codified before the age of 50, with surgery being preferred, recommendations for older individuals are less clear.

However, this indication must be weighed against the patient's co-morbidities, frailty and wishes.

Drug-based alternatives are a valid option for patients unable or unwilling to undergo surgery.

The fundamental question, however, is to evaluate the suitability of one treatment over another, depending on the patient's phenotype.