The role of thyrotropin suppression in patients with differentiated thyroid carcinoma.

Hdl Handle:
http://hdl.handle.net/10147/122676
Title:
The role of thyrotropin suppression in patients with differentiated thyroid carcinoma.
Authors:
Deasy, J; Prichard, R S; Evoy, D; McDermott, E W
Affiliation:
Department of Surgery, St Vincent's University Hospital, Elm Park, Dublin 4.
Citation:
The role of thyrotropin suppression in patients with differentiated thyroid carcinoma., 103 (7):202-5 Ir Med J
Journal:
Irish medical journal
Issue Date:
Jul-2010
URI:
http://hdl.handle.net/10147/122676
PubMed ID:
20845598
Abstract:
Thyroid carcinoma is the commonest endocrine malignancy. The majority of these are differentiated thyroid carcinomas, which have a good overall prognosis. Treatment includes surgical excision, radio-iodine ablation and long-term thyrotropin suppression. The degree and length of suppression required, as well as the potential side-effect remain controversial. Therefore, the aim of this study was to establish the degree of thyrotropin suppression achieved in a cohort of patients with differentiated thyroid carcinoma. A retrospective review was performed of a prospectively maintained database. All patients with a diagnosis of differentiated thyroid carcinoma between January 1998 and January 2008 were identified. Demographic data, pathological stage and the treatment that the patient received was documented. TSH and free T4 levels were identified at specific time points post-operatively. Eighty-eight patients with differentiated thyroid carcinoma were identified. Seventy patients (79.5%) were female. The mean age was 55, with a range of 18 to 79 years. The majority of patients underwent a total thyroidectomy (n=79; 89.7%) and of those 29 (32.9%) had an associated modified neck dissection. Accurate follow-up was available on forty-nine patients. TSH and free T4 were measured at 3 and 6 months, as well as at 1 and 2 years post-operatively. Adequate TSH suppression was taken at a level < 0.1 mU/L. The majority of patients (69.5%) had achieved adequate TSH suppression at 2 years. However, 65% of these same patients had a high free T4 at 2 years indicating a degree of hyperthyroidism. This study has demonstrated that TSH suppression is being adequately achieved in the majority of patients with differentiated thyroid carcinoma. However, this must be carefully weighed against the potential detrimental side-effects of long-term sub-clinical hyperthyroidism.
Item Type:
Article
Language:
en
MeSH:
Adolescent; Adult; Aged; Female; Humans; Lymph Node Excision; Male; Middle Aged; Retrospective Studies; Thyroid Neoplasms; Thyroidectomy; Thyrotropin; Thyroxine; Young Adult
ISSN:
0332-3102

Full metadata record

DC FieldValue Language
dc.contributor.authorDeasy, Jen
dc.contributor.authorPrichard, R Sen
dc.contributor.authorEvoy, Den
dc.contributor.authorMcDermott, E Wen
dc.date.accessioned2011-02-22T15:21:30Z-
dc.date.available2011-02-22T15:21:30Z-
dc.date.issued2010-07-
dc.identifier.citationThe role of thyrotropin suppression in patients with differentiated thyroid carcinoma., 103 (7):202-5 Ir Med Jen
dc.identifier.issn0332-3102-
dc.identifier.pmid20845598-
dc.identifier.urihttp://hdl.handle.net/10147/122676-
dc.description.abstractThyroid carcinoma is the commonest endocrine malignancy. The majority of these are differentiated thyroid carcinomas, which have a good overall prognosis. Treatment includes surgical excision, radio-iodine ablation and long-term thyrotropin suppression. The degree and length of suppression required, as well as the potential side-effect remain controversial. Therefore, the aim of this study was to establish the degree of thyrotropin suppression achieved in a cohort of patients with differentiated thyroid carcinoma. A retrospective review was performed of a prospectively maintained database. All patients with a diagnosis of differentiated thyroid carcinoma between January 1998 and January 2008 were identified. Demographic data, pathological stage and the treatment that the patient received was documented. TSH and free T4 levels were identified at specific time points post-operatively. Eighty-eight patients with differentiated thyroid carcinoma were identified. Seventy patients (79.5%) were female. The mean age was 55, with a range of 18 to 79 years. The majority of patients underwent a total thyroidectomy (n=79; 89.7%) and of those 29 (32.9%) had an associated modified neck dissection. Accurate follow-up was available on forty-nine patients. TSH and free T4 were measured at 3 and 6 months, as well as at 1 and 2 years post-operatively. Adequate TSH suppression was taken at a level < 0.1 mU/L. The majority of patients (69.5%) had achieved adequate TSH suppression at 2 years. However, 65% of these same patients had a high free T4 at 2 years indicating a degree of hyperthyroidism. This study has demonstrated that TSH suppression is being adequately achieved in the majority of patients with differentiated thyroid carcinoma. However, this must be carefully weighed against the potential detrimental side-effects of long-term sub-clinical hyperthyroidism.-
dc.language.isoenen
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshLymph Node Excision-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshRetrospective Studies-
dc.subject.meshThyroid Neoplasms-
dc.subject.meshThyroidectomy-
dc.subject.meshThyrotropin-
dc.subject.meshThyroxine-
dc.subject.meshYoung Adult-
dc.titleThe role of thyrotropin suppression in patients with differentiated thyroid carcinoma.en
dc.typeArticleen
dc.contributor.departmentDepartment of Surgery, St Vincent's University Hospital, Elm Park, Dublin 4.en
dc.identifier.journalIrish medical journalen

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