Recurrent goiters: risk factors, patient quality of life, and efficacy of radioiodine therapy.

Recurrent goiters: risk factors, patient quality of life, and efficacy of radioiodine therapy.

Pol Arch Intern Med. 2018 Dec 05;:

Authors: Sawicka-Gutaj N, Ziółkowska P, Sowiński J, Czarnywojtek A, Milczarczyk K, Gut P, Ruchała M

Abstract
INTRODUCTION Goiter recurrence occurs in a substantial number of patients after thyroid resection. OBJECTIVES We aimed to investigate the prevalence and risk factors of recurrent goiters, influence of goiter recurrence on patient quality of life (QoL) and the efficacy of therapy with radioactive iodine (RAI). PATIENTS AND METHODS This was a case-control study. All thyroidectomized patients admitted within the past year to the outpatient department were included in the study and their medical records were analyzed. Recurrence was defined as nodular lesions within the remnant tissue or enlargement of the remaining thyroid tissue which required therapy (reoperation or radioiodine). Clinical and biochemical data were collected. Randomly selected patients were asked to answer ThyPROpl for health-related QoL assessment; 30 healthy subjects were recruited for comparison. RESULTS 481 out of 538 patients were included in the study: 68 patients with a recurrent goiter and 413 without recurrence. Higher TSH at follow-up and lobectomy were the strongest risk factors for goiter recurrence, followed by a longer observation period. Postoperative LT4 therapy was associated with a lower risk of recurrence. Efficacy of RAI was similar to secondary thyroidectomy. Scores in all comparable scales for patients with recurrent goiters were significantly worse than those in the general population. CONCLUSIONS Lobectomies should be avoided as a primary surgical treatment for benign thyroid diseases, and levothyroxine therapy should be individually considered in each patient.Radioiodine therapy seems to be a safe and effective treatment option for recurrent goiters. Recurrent goiters, although successfully treated, have a negative impact on QoL.

PMID: 30516760 [PubMed - as supplied by publisher]

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