The Necessity of Thyroid-stimulating Hormone Suppression Therapy for Low-risk Differentiated Thyroid Carcinoma Following Hemithyroidectomy: A Systematic Review and Meta-analysis

Background And Objective: Thyroidectomy, followed by postoperative thyroid-stimulating hormone (TSH) suppression therapy, is the established therapeutic approach for low-risk differentiated thyroid carcinoma (DTC). Recently, there has been a growing body of research dedicated to postoperative TSH suppression therapy in low-risk DTC. This study aims to conduct a comprehensive literature review concerning the necessity of TSH suppression therapy in DTC after hemithyroidectomy.

Methods: A systematic search of publicly available literature on postoperative TSH suppression therapy in DTC was conducted by querying databases such as PubMed, Embase, Cochrane, and Web of Science. Patients were stratified into two groups: the experimental group (patients who received TSH suppression therapy) and the control group (patients who did not receive TSH suppression therapy). Concurrently, the five selected studies were categorized into two groups based on the average follow-up period (5-8.6 years).

Results: A total of five eligible studies, involving 2964 participants, were included in the analysis. The analysis of these five studies indicated low heterogeneity (I = 40 %). During the follow-up period, patients who received TSH suppression therapy had similar recurrence rate ( = 0.13) compared to those who did not. In both average follow-up period less than 6 years group ( = 0.85) and more than or equal to 6 years group ( = 0.07), postoperative TSH suppression therapy did not affect the recurrence of DTC after hemithyroidectomy.

Conclusion: This study demonstrates that postoperative TSH suppression therapy does not reduce the recurrence rate of low-risk DTC patients after hemithyroidectomy.