2015 American Thyroid Association guidelines and t hyroid‐stimulating hormone suppression after thyroid lobectomy
| Autor: | Katherine L. Fedder, Robert Reed, David C. Shonka, Mark J. Jameson, Kaitlin J. Kavanagh, Andrew Strumpf, Teresa G. Martz |
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| Rok vydání: | 2020 |
| Předmět: |
endocrine system
medicine.medical_specialty endocrine system diseases Population Levothyroxine Thyrotropin 030209 endocrinology & metabolism Thyroid Lobectomy 03 medical and health sciences 0302 clinical medicine Thyroid-stimulating hormone Chart review medicine Humans Thyroid Neoplasms education Thyroid cancer Retrospective Studies education.field_of_study business.industry Thyroid medicine.disease United States Surgery Thyroxine medicine.anatomical_structure Otorhinolaryngology 030220 oncology & carcinogenesis Thyroidectomy business Hormone medicine.drug |
| Zdroj: | Head & Neck. 43:639-644 |
| ISSN: | 1097-0347 1043-3074 |
| Popis: | Background 2015 American Thyroid Association (ATA) guidelines recommended more conservative treatment in low-risk well-differentiated thyroid cancer (WDTC), stating that lobectomy alone may be sufficient. The guidelines further recommend mild thyroid-stimulating hormone (TSH) level suppression (0.5-2 mU/L) for this population. Our goal is to evaluate the natural history of patients undergoing lobectomy to determine the percentage that would require postoperative levothyroxine supplementation under these guidelines. Methods Retrospective chart review of 168 patients that underwent lobectomy between 2010 and 2019 was performed. Preoperative and postoperative TSH values and the rate of patients prescribed levothyroxine were analyzed. Results Thirty-five percent of patients were prescribed levothyroxine postoperatively. At 6 weeks postoperatively, 66% had TSH value of >2; this increased to 76% by 6 to 12 months. Conclusion To adhere to ATA guidelines for WDTC managed with lobectomy alone, the majority of patients (76%) would require postoperative levothyroxine supplementation. Low preoperative TSH was found to be the most significant predictor for postoperative TSH |
| Databáze: | OpenAIRE |
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