Risk factors of recurrent secondary hyperparathyroidism after adequate primary surgical treatment.

Therefore, recurrence may be inevitable; the curve of cumulative incidence demonstrated an increasing trend, which coincided with our result ( Supplementary Figure 1 ), and more residual parathyroid tissue may predispose patients to recurrence.

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While missed orthotopic or ectopic glands and supernumeraries are major risk factors for persistent disease ( 13 ), the number of identified glands during the primary surgery may not be significant once an adequate treatment effect is achieved, namely, no persistent disease.

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