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Optimal Thyrotropin Suppression Therapy in Low-Risk Thyroid Cancer Patients after Lobectomy

Background: This study aimed to identify the clinical results after thyrotropin suppression therapy (TST) cessation and evaluated clinical factors associated with successful TST cessation. Methods: Patients who underwent lobectomy due to low-risk papillary thyroid carcinoma (PTC) were included in th...

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Autores principales: Lee, Yu-Mi, Jeon, Min Ji, Kim, Won Woong, Sung, Tae-Yon, Chung, Ki-Wook, Shong, Young Kee, Hong, Suck Joon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780946/
https://www.ncbi.nlm.nih.gov/pubmed/31443521
http://dx.doi.org/10.3390/jcm8091279
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author Lee, Yu-Mi
Jeon, Min Ji
Kim, Won Woong
Sung, Tae-Yon
Chung, Ki-Wook
Shong, Young Kee
Hong, Suck Joon
author_facet Lee, Yu-Mi
Jeon, Min Ji
Kim, Won Woong
Sung, Tae-Yon
Chung, Ki-Wook
Shong, Young Kee
Hong, Suck Joon
author_sort Lee, Yu-Mi
collection PubMed
description Background: This study aimed to identify the clinical results after thyrotropin suppression therapy (TST) cessation and evaluated clinical factors associated with successful TST cessation. Methods: Patients who underwent lobectomy due to low-risk papillary thyroid carcinoma (PTC) were included in this study. We compared clinical characteristics and outcomes between patients who succeeded to stop TST and failed to stop TST. Results: A total of 363 patients were included in the study. One hundred and ninety-three patients (53.2%, 193/363) succeeded to stop TST. The independent associated factors for successful TST cessation were the preoperative thyroid-stimulating hormone (TSH) level and the maintenance period of TST. Patients with low TSH level showed a higher success rate for levothyroxine (LT4) cessation than patients with high TSH level (1.79 ± 1.08 and 2.76 ± 1.82 mU/L, p < 0.001). Patients who failed to discontinue TST showed a longer maintenance period of TST than patients who succeeded to discontinue TST (54.09 ± 17.44 and 37.58 ± 17.68 months, p < 0.001). Conclusions: Preoperative TSH level and maintenance period of TST are important factors for successful cessation of TST. If TST cessation is planned for patients who are taking LT4 after lobectomy, a higher success rate of TST cessation is expected with low preoperative TSH level and early cessation of LT4.
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spelling pubmed-67809462019-10-30 Optimal Thyrotropin Suppression Therapy in Low-Risk Thyroid Cancer Patients after Lobectomy Lee, Yu-Mi Jeon, Min Ji Kim, Won Woong Sung, Tae-Yon Chung, Ki-Wook Shong, Young Kee Hong, Suck Joon J Clin Med Article Background: This study aimed to identify the clinical results after thyrotropin suppression therapy (TST) cessation and evaluated clinical factors associated with successful TST cessation. Methods: Patients who underwent lobectomy due to low-risk papillary thyroid carcinoma (PTC) were included in this study. We compared clinical characteristics and outcomes between patients who succeeded to stop TST and failed to stop TST. Results: A total of 363 patients were included in the study. One hundred and ninety-three patients (53.2%, 193/363) succeeded to stop TST. The independent associated factors for successful TST cessation were the preoperative thyroid-stimulating hormone (TSH) level and the maintenance period of TST. Patients with low TSH level showed a higher success rate for levothyroxine (LT4) cessation than patients with high TSH level (1.79 ± 1.08 and 2.76 ± 1.82 mU/L, p < 0.001). Patients who failed to discontinue TST showed a longer maintenance period of TST than patients who succeeded to discontinue TST (54.09 ± 17.44 and 37.58 ± 17.68 months, p < 0.001). Conclusions: Preoperative TSH level and maintenance period of TST are important factors for successful cessation of TST. If TST cessation is planned for patients who are taking LT4 after lobectomy, a higher success rate of TST cessation is expected with low preoperative TSH level and early cessation of LT4. MDPI 2019-08-22 /pmc/articles/PMC6780946/ /pubmed/31443521 http://dx.doi.org/10.3390/jcm8091279 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lee, Yu-Mi
Jeon, Min Ji
Kim, Won Woong
Sung, Tae-Yon
Chung, Ki-Wook
Shong, Young Kee
Hong, Suck Joon
Optimal Thyrotropin Suppression Therapy in Low-Risk Thyroid Cancer Patients after Lobectomy
title Optimal Thyrotropin Suppression Therapy in Low-Risk Thyroid Cancer Patients after Lobectomy
title_full Optimal Thyrotropin Suppression Therapy in Low-Risk Thyroid Cancer Patients after Lobectomy
title_fullStr Optimal Thyrotropin Suppression Therapy in Low-Risk Thyroid Cancer Patients after Lobectomy
title_full_unstemmed Optimal Thyrotropin Suppression Therapy in Low-Risk Thyroid Cancer Patients after Lobectomy
title_short Optimal Thyrotropin Suppression Therapy in Low-Risk Thyroid Cancer Patients after Lobectomy
title_sort optimal thyrotropin suppression therapy in low-risk thyroid cancer patients after lobectomy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780946/
https://www.ncbi.nlm.nih.gov/pubmed/31443521
http://dx.doi.org/10.3390/jcm8091279
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