Prognostic Implications of Maintaining the Target Thyroid-Stimulating Hormone Status Based on the 2015 American Thyroid Association Guidelines in Patients with Low-Risk Papillary Thyroid Carcinoma After Lobectomy: A 5-Year Landmark Analysis

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2024 Oct 16

PMID 39409875

Authors

Ye Won Jeon

Young Jin Suh

Seung Taek Lim

Affiliations

Soon will be listed here.

Abstract

: The 2015 American Thyroid Association guidelines recommend the maintenance of serum thyroid stimulating hormone (TSH) levels ≤2 mIU/L in patients with low-risk papillary thyroid carcinoma (PTC) who underwent lobectomy; however, the evidence is insufficient. We investigated the association between maintaining the TSH status at ≤2 mIU/L and tumor recurrence in patients with low-risk PTC who underwent lobectomy through a 5-year landmark analysis. : Between 2010 and 2016, 662 patients with low-risk PTC were included. The postoperative TSH status was determined using the 'TSH > 2 ratio', which was calculated using the TSH test results during the 5-year follow-up. The optimal cutoff value of 'TSH > 2 ratio' for tumor recurrence was determined using a receiver operating characteristic curve analysis. Recurrence-free survival (RFS) was compared between the groups using Kaplan-Meier and Cox proportional hazard regression analyses. : Patients with 'TSH > 2 ratio' > 0.1833 ( = 498) had a worse RFS outcome compared to patients with 'TSH > 2 ratio' ≤ 0.1833 ( = 164; < 0.001). 'TSH > 2 ratio' > 0.1833 was a significant risk factor for tumor recurrence after the 5-year landmark (hazard ratio: 4.795, 95% confidence interval: 2.102-10.937, < 0.001). : Maintaining TSH levels ≤ 2 mIU/L below a certain percentage among the total TSH tests during the 5-year follow-up period has a negative impact on tumor recurrence.

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