Preventive effect of levothyroxine in patients operated for non-toxic goitre: a randomized trial of one hundred patients with nine years follow-up

Abstract

Objective: Earlier reports have shown different effects of levothyroxine in the prevention of recurrence of non-toxic goitre after operation. These studies have been either retrospective or of short-term follow-up. This study was designed to evaluate the efficacy of long-term Eltroxin treatment (levothyroxine 0.1 mg daily) in the prevention of post-operative recurrence of non-toxic goitre.

Design: Randomized prospective non-placebo controlled study with 9 years follow-up. Group A (n = 40) received levothyroxine and group B (n = 60) did not.

Patients: One hundred patients consecutively operated for non-toxic goitre. All clinically and biochemically euthyroid and none taking any thyroid and/or antithyroid medication.

Measurements: T3, T4, TSH, thyroid antibodies (microsomal/thyroglobulin), weight and neck circumference were measured and thyroid palpation were done preoperatively, 3 and 12 months after surgery and thereafter yearly up to 9 years.

Results: Sixty-nine patients completed 9 years follow-up. Incidence of recurrence in group A vs group B was 14.5 vs 21.8% (P < 0.05) irrespective of type of operation, pathoanatomical diagnosis, removed amount or remnant size of the thyroid gland and level of TSH.

Conclusion: No preventive effect on incidence of recurrence of goitre by Eltroxin 0.1 mg daily in patients operated for non-toxic sporadic goitre was observed.