Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jun;34(2):150-157.
doi: 10.3803/EnM.2019.34.2.150. Epub 2019 Mar 19.

Postoperative Thyroid-Stimulating Hormone Levels Did Not Affect Recurrence after Thyroid Lobectomy in Patients with Papillary Thyroid Cancer

Myung Chul Lee  1 , Min Joo Kim  2   3 , Hoon Sung Choi  4 , Sun Wook Cho  2 , Guk Haeng Lee  1 , Young Joo Park  2 , Do Joon Park  2
Affiliations

Postoperative Thyroid-Stimulating Hormone Levels Did Not Affect Recurrence after Thyroid Lobectomy in Patients with Papillary Thyroid Cancer

Myung Chul Lee et al. Endocrinol Metab (Seoul). 2019 Jun.

Abstract

Background: Thyroid-stimulating hormone (TSH) suppression is recommended for patients who undergo thyroidectomy for differentiated thyroid cancer (DTC). However, the impact of TSH suppression on clinical outcomes in low-risk DTC remains uncertain. Therefore, we investigated the effects of postoperative TSH levels on recurrence in patients with low-risk DTC after thyroid lobectomy.

Methods: Patients (n=1,528) who underwent thyroid lobectomy for papillary thyroid carcinoma between 2000 and 2012 were included in this study. According to the mean and dominant TSH values during the entire follow-up period or 5 years, patients were divided into four groups (<0.5, 0.5 to 1.9, 2.0 to 4.4, and ≥4.5 mIU/L). Recurrence-free survival was compared among the groups.

Results: During the 5.6 years of follow-up, 21 patients (1.4%) experienced recurrence. Mean TSH levels were within the recommended low-normal range (0.5 to 1.9 mIU/L) during the total follow-up period or 5 years in 38.1% or 36.0% of patients. The mean and dominant TSH values did not affect recurrence-free survival. Adjustment for other risk factors did not alter the results.

Conclusion: Serum TSH levels did not affect short-term recurrence in patients with low-risk DTC after thyroid lobectomy. TSH suppression should be conducted more selectively.

Keywords: Recurrence; Thyroid cancer, papillary; Thyroid neoplasms; Thyrotropin.

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Kaplan-Meier curves of recurrence-free survival (RFS). (A) Tumor size. (B) Mean thyroid-stimulating hormone levels for 5 years after surgery (TSH5yrs) values. (C) Dominant TSH5yrs values. (D) Levothyroxine use.
Fig. 2
Fig. 2. Forest plot for recurrence-free survival according to the mean thyroid-stimulating hormone (TSH) values during the total follow-up period or 5 years. In multivariate Cox regression analysis, known risk factors including age, sex, tumor size, multiplicity, extrathyroidal extension, and lymph node metastasis were adjusted. (A) Univariate Cox regression analysis with mean TSH values were calculated (TSHtotal) values. (B) Multivariate Cox regression analysis with mean TSHtotal values. (C) Univariate Cox regression analysis with mean TSH levels for 5 years after surgery (TSH5yrs) values. (D) Multivariate Cox regression analysis with mean TSH5yrs values. HR, hazard ratio; CI, confidence interval.
See this image and copyright information in PMC

References

    1. Moon JH, Kim KM, Oh TJ, Choi SH, Lim S, Park YJ, et al. The effect of TSH suppression on vertebral trabecular bone scores in patients with differentiated thyroid carcinoma. J Clin Endocrinol Metab. 2017;102:78–85. - PubMed
    1. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association Management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26:1–133. - PMC - PubMed
    1. Pötter E, Horn R, Scheumann GF, Dralle H, Costagliola S, Ludgate M, et al. Western blot analysis of thyrotropin receptor expression in human thyroid tumours and correlation with TSH-binding. Biochem Biophys Res Commun. 1994;205:361–367. - PubMed
    1. Brabant G. Thyrotropin suppressive therapy in thyroid carcinoma: what are the targets? J Clin Endocrinol Metab. 2008;93:1167–1169. - PubMed
    1. Cooper DS, Specker B, Ho M, Sperling M, Ladenson PW, Ross DS, et al. Thyrotropin suppression and disease progression in patients with differentiated thyroid cancer: results from the National Thyroid Cancer Treatment Cooperative Registry. Thyroid. 1998;8:737–744. - PubMed