Levothyroxine therapy in preventing nodular recurrence after hemithyroidectomy: a retrospective study

Area of Science:

• Endocrinology
• Thyroid Surgery
• Pharmacology

Background:

• Benign nodular goiter is a common thyroid condition.
• Lobectomy is a surgical option for managing benign nodular goiter.
• Recurrence of nodular disease after surgery is a clinical concern.

Purpose of the Study:

• To evaluate the impact of levothyroxine (L-T4) therapy on the recurrence rate of nodular disease.
• To compare recurrence rates in patients treated with and without L-T4 post-lobectomy.
• To investigate whether TSH suppression is required for recurrence prevention.

Main Methods:

• A cohort of 233 patients who underwent lobectomy for benign nodular goiter were followed annually.
• Patients were monitored using serum TSH levels and ultrasound (US) for nodular recurrence (lesion ≥ 5 mm).
• Patients were divided into a control group (no L-T4) and an L-T4 treated group (substitutive or suppressive doses).

Main Results:

• The overall recurrence rate was 30.5% (71/233 patients).
• Patients receiving L-T4 therapy (Group 2) had a significantly lower recurrence rate (19.5%-27.7%) compared to those without L-T4 (Group 1, 64.4%; p<0.001).
• No significant difference in recurrence rates was found between L-T4 substitutive and TSH-suppressive doses.

Conclusions:

• Levothyroxine (L-T4) therapy following hemithyroidectomy for benign monolobar nodular disease may prevent recurrence.
• TSH suppression is not essential for preventing nodular disease recurrence in the remaining thyroid tissue.