Treatment of patients with toxic multinodular goiter.

The medical records of 253 patients evaluated for toxic multinodular goiter from 1975 through 1993 were reviewed to determine treatment trends, success, and complications. Of the 235 (93%) treated, 174 (74%) received surgical treatment and 61 (26%) received radioiodine (131I) treatment. Three months after initial treatment, 82% of surgically treated patients became euthyroid or hypothyroid compared with 21% of the 131I group. Among the 131I-treated patients, 20% required a second treatment, whereas none needed further treatment in the surgical group. At 2 years, the estimated probability of success was similar. The probability of post-treatment hypothyroidism was significantly higher for surgically treated patients, which is expected.