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

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Abstract

Aim: To determine the effect of levothyroxine (L-T4) therapy on the recurrence rate of nodular disease in patients previously treated with lobectomy for benign nodular goiter. Methods: Two hundred and thirty-tree patients (38 males, 195 females; age 49.9±13.1 yr) with no post-surgical evidence of nodular disease in the remnant, were followed-up yearly with serum TSH and ultrasound (US). Nodular recurrence was defined as a lesion of at least 5 mm at US. Patients were divided in 2 groups based on whether or not they had been treated with L-T4 after surgery: Group 1 (45 patients) who did not receive any L-T4, and Group 2 (188 patients) treated with L-T4. Group 2 was further subdivided in Group 2a (123 patients) receiving L-T4 substitutive therapy (TSH≥0.5 and ≤3 mUI/l) and Group 2b (65 patients) receiving L-T4 at TSH-suppressive dose (TSH<0.5 mUI/l). Results: Mean observation period was 5.8±4.7 yr. Overall, 71 out of 233 (30.5%) patients experienced recurrence of thyroid nodular disease: 29 patients (64.4%) in Group 1, 24 (19.5%) patients in Group 2a, and 18 (27.7%) patients in Group 2b. The recurrence rate was significantly lower (p<0.001) in Group 2 compared with Group 1, but no significant difference was observed between Groups 2a and 2b. Conclusion: In patients who have undergone hemithyroidectomy for benign monolobar nodular disease, L-T4 therapy may prevent recurrence of nodular disease. TSH suppression may not be required for prevention of recurrence in the remnant thyroid tissue.

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Authors and Affiliations

  1. Endocrinology Unit, Catholic University of Sacred Heart, Via Federico Cesi, 72, 00193, Rome, Italy

    M. Alba, R. M. Lovicu, R. M. Paragliola, C. A. Rota, A. Pontecorvi & S. M. Corsello MD

  2. Endocrinology Unit, Bambino Gesù Children Hospital, IRCCS, Rome

    D. Fintini

  3. Department of Internal Medicine, AUSL, Modena, Italy

    G. Papi

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  1. M. Alba
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  2. D. Fintini
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Alba, M., Fintini, D., Lovicu, R.M. et al. Levothyroxine therapy in preventing nodular recurrence after hemithyroidectomy: A retrospective study. J Endocrinol Invest 32, 330–334 (2009). https://doi.org/10.1007/BF03345722

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