Caroline Cox1, Maggie Bosley1, Lori Beth Southerland1, Sara Ahmadi2, Jennifer Perkins2, Sanziana Roman3, Julie Ann Sosa3, Denise Carneiro-Pla4. 1. Division of Oncologic and Endocrine Surgery, Medical University of South Carolina, Charleston, SC. 2. Division of Endocrinology, Duke University Medical Center, Durham, NC. 3. Section of Endocrine Surgery, Department of Surgery, Duke University Medical Center, Duke Cancer Institute, Durham, NC. 4. Division of Oncologic and Endocrine Surgery, Medical University of South Carolina, Charleston, SC. Electronic address: carneiro@musc.edu.
Abstract
BACKGROUND: The American Thyroid Association recommended thyroid lobectomy as an alternative for low-risk differentiated thyroid cancer. One hypothetical benefit includes avoiding lifelong thyroid hormone supplementation; however, guidelines recommend maintaining the thyroid-stimulating hormone <2 mIU/L postoperatively in low-risk patients. Our hypothesis is that most patients will require hormone supplementation to maintain thyroid-stimulating hormone <2 mIU/L, minimizing this advantage of lobectomy. The goal of this study is to determine how often patients have thyroid-stimulating hormone <2 mIU/L after lobectomy without thyroid hormone supplementation. METHODS: A retrospective review of 555 consecutive patients who underwent thyroid lobectomy was performed. Thyroid hormone supplementation was documented, along with thyroid-stimulating hormone levels preoperatively, 7 to 10 days, and 2 to 12 months postoperatively. RESULTS: In the study, 478/555 (86%) patients did not take thyroid hormone before thyroidectomy; 394/478 (82%) had thyroid-stimulating hormone levels available at 7 to 10 days postoperatively, and of these, 218 (55%) had thyroid-stimulating hormone >2 mIU/L. From 2 to 12 months postoperatively, of the 225 patients who continued to remain off thyroid hormone supplementation, 132 (59%) experienced a thyroid-stimulating hormone increase to >2 mIU/L; therefore, 350/478 (73%) patients after thyroid lobectomy had thyroid-stimulating hormone levels >2 mIU/L within a year. CONCLUSION: It is important to counsel patients that to be compliant with the American Thyroid Association guidelines for differentiated thyroid cancer, the majority of patients undergoing thyroid lobectomy may require thyroid hormone supplementation to maintain a thyroid-stimulating hormone level <2 m IU/L.
BACKGROUND: The American Thyroid Association recommended thyroid lobectomy as an alternative for low-risk differentiated thyroid cancer. One hypothetical benefit includes avoiding lifelong thyroid hormone supplementation; however, guidelines recommend maintaining the thyroid-stimulating hormone <2 mIU/L postoperatively in low-risk patients. Our hypothesis is that most patients will require hormone supplementation to maintain thyroid-stimulating hormone <2 mIU/L, minimizing this advantage of lobectomy. The goal of this study is to determine how often patients have thyroid-stimulating hormone <2 mIU/L after lobectomy without thyroid hormone supplementation. METHODS: A retrospective review of 555 consecutive patients who underwent thyroid lobectomy was performed. Thyroid hormone supplementation was documented, along with thyroid-stimulating hormone levels preoperatively, 7 to 10 days, and 2 to 12 months postoperatively. RESULTS: In the study, 478/555 (86%) patients did not take thyroid hormone before thyroidectomy; 394/478 (82%) had thyroid-stimulating hormone levels available at 7 to 10 days postoperatively, and of these, 218 (55%) had thyroid-stimulating hormone >2 mIU/L. From 2 to 12 months postoperatively, of the 225 patients who continued to remain off thyroid hormone supplementation, 132 (59%) experienced a thyroid-stimulating hormone increase to >2 mIU/L; therefore, 350/478 (73%) patients after thyroid lobectomy had thyroid-stimulating hormone levels >2 mIU/L within a year. CONCLUSION: It is important to counsel patients that to be compliant with the American Thyroid Association guidelines for differentiated thyroid cancer, the majority of patients undergoing thyroid lobectomy may require thyroid hormone supplementation to maintain a thyroid-stimulating hormone level <2 m IU/L.
Authors: Dana M Hartl; Joanne Guerlain; Ingrid Breuskin; Julien Hadoux; Eric Baudin; Abir Al Ghuzlan; Marie Terroir-Cassou-Mounat; Livia Lamartina; Sophie Leboulleux Journal: Cancers (Basel) Date: 2020-11-06 Impact factor: 6.639
Authors: Eun Kyung Lee; Yea Eun Kang; Young Joo Park; Bon Seok Koo; Ki-Wook Chung; Eu Jeong Ku; Ho-Ryun Won; Won Sang Yoo; Eonju Jeon; Se Hyun Paek; Yong Sang Lee; Dong Mee Lim; Yong Joon Suh; Ha Kyoung Park; Hyo-Jeong Kim; Bo Hyun Kim; Mijin Kim; Sun Wook Kim; Ka Hee Yi; Sue K Park; Eun-Jae Jung; June Young Choi; Ja Seong Bae; Joon Hwa Hong; Kee-Hyun Nam; Young Ki Lee; Hyeong Won Yu; Sujeong Go; Young Mi Kang Journal: Endocrinol Metab (Seoul) Date: 2021-05-26