Is Maintaining Thyroid-Stimulating Hormone Effective in Patients Undergoing Thyroid Lobectomy for Low-Risk Differentiated Thyroid Cancer? A Systematic Review and Meta-Analysis

被引：10

作者：

Won, Ho-Ryun ^{[1
,2
]}

Jeon, Eonju ^{[3
]}

Chang, Jae Won ^{[1
,4
]}

Kang, Yea Eun ^{[5
]}

Song, Kunho ^{[4
]}

Kim, Sun Wook ^{[6
]}

Lim, Dong Mee ^{[7
]}

Ha, Tae Kwun ^{[8
]}

Chung, Ki-Wook ^{[9
]}

Kim, Hyo-Jeong ^{[10
]}

Park, Young Joo ^{[11
]}

Koo, Bon Seok ^{[1
,4
]}

机构：

[1] Chungnam Natl Univ, Dept Otorhinolaryngol Head & Neck Surg, Coll Med, Daejeon 35015, South Korea

[2] Chungnam Natl Univ, Dept Otorhinolaryngol Head & Neck Surg, Sejong Hosp, Sejong 30099, South Korea

[3] Daegu Catholic Univ, Dept Internal Med, Sch Med, Daegu 42472, South Korea

[4] Chungnam Natl Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Daejeon 35015, South Korea

[5] Chungnam Natl Univ Hosp, Dept Internal Med, Div Endocrinol & Metab, Daejeon 35015, South Korea

[6] Sungkyunkwan Univ, Dept Med, Div Endocrinol & Metab, Sch Med, Seoul 16419, South Korea

[7] Konyang Univ Hosp, Dept Internal Med, Daejeon 35365, South Korea

[8] Inje Univ, Dept Surg, Busan Paik Hosp, Busan 47392, South Korea

[9] Ulsan Univ, Dept Surg, Coll Med, Seoul 05505, South Korea

[10] Eulji Univ, Dept Internal Med, Coll Med, Daejeon 34824, South Korea

[11] Seoul Natl Univ, Dept Internal Med, Coll Med, Seoul 03080, South Korea

来源：

CANCERS | 2022年 / 14卷 / 06期

基金：

新加坡国家研究基金会;

关键词：

thyroid cancer; differentiated thyroid cancer; thyroid-stimulating hormone; thyroid lobectomy; recurrence rate; TERM-FOLLOW-UP; THYROTROPIN SUPPRESSION; NECK DISSECTION; PAPILLARY; RECURRENCE; THERAPY; HEMITHYROIDECTOMY; CARCINOMA; IMPACT; LEVOTHYROXINE;

D O I：

10.3390/cancers14061470

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Simple Summary In order to reduce the recurrence rate after surgical treatment of differentiated thyroid cancer (DTC), suppression of thyroid-stimulating hormone (TSH) or maintenance of a certain level after surgery are important. However, the effectiveness of TSH maintenance in the mid to lower reference range (0.5-2 mU/L) in patients undergoing thyroid lobectomy for low-risk DTC is uncertain. In this systematic review and meta-analysis, we compared and analyzed the recurrence rate according to whether TSH maintenance was performed in patients who underwent thyroid lobectomy for low-risk DTC. There was no difference in the recurrence rate with or without TSH control. Therefore, the recommendation to maintain TSH to reduce the recurrence rate after thyroid lobectomy is still controversial. There is no clear evidence that post-operative maintenance of thyroid-stimulating hormone (TSH) in the mid to lower reference range (0.5-2 mU/L) improves prognosis in patients undergoing thyroid lobectomy for low-risk differentiated thyroid cancer (DTC). The purpose of this systematic review and meta-analysis was to compare and analyze the recurrence rate according to whether the serum TSH level was maintained below 2 mU/L in patients who underwent thyroid lobectomy for low-risk DTC. Clinical data and outcomes were collected from MEDLINE, Embase, and the Cochrane Database of Systematic Reviews. The inclusion criteria were related studies on TSH maintenance or serum TSH concentration after surgery for DTC. Seven observational studies with a total of 3974 patients were included in this study. In the patients who received TSH maintenance less than 2 mU/L, the recurrence rate during the follow-up period was 2.3%. A subgroup analysis of five studies showed that the odds ratio for recurrence in patients who received TSH maintenance was 1.45 (p-value = 0.45) compared to patients who did not receive TSH maintenance. In conclusion, the evidence for the effectiveness of post-operative TSH maintenance less than 2 mU/L in patients undergoing thyroid lobectomy for low-risk DTC is insufficient.

引用

页数：13

共 43 条

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