PDF herunterladen
CC BY 4.0 · Int Arch Otorhinolaryngol 2025; 29(02): s00451801852
DOI: 10.1055/s-0045-1801852
Original Research

Role of Preoperative Thyroid-Stimulating Hormone Levels in the Prediction of Thyroid Hormone Replacement after Hemithyroidectomy

Ramona Paula Fernandes Reckziegel
1   Endocrinology Service, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre, RS, Brazil
,
Lenara Golbert
1   Endocrinology Service, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre, RS, Brazil
,
Erika Laurini de Souza Meyer 
1   Endocrinology Service, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre, RS, Brazil
› Institutsangaben
Funding The authors declare that they did not receive funding from agencies in the public, private or non-profit sectors to conduct the present study.
› Weitere Informationen
Auch verfügbar auf
  Lizenzen und Reprints

Abstract

Introduction Hemithyroidectomy is performed for the treatment of symptomatic unilateral benign nodules, cytologically indeterminate nodules, and some cases of well-differentiated thyroid cancer.

Objective To evaluate the frequency of postlobectomy thyroid hormone replacement (THR), and to analyze the clinical-pathological factors predicting L-thyroxine (T4) use in patients undergoing hemithyroidectomy.

Methods We conducted an observational, retrospective study in which clinical, biochemical, and anatomopathological parameters were analyzed and correlated with the need for THR after thyroid lobectomy.

Results The frequency of postoperative THR was 63%. The preoperative thyroid-stimulating hormone (TSH) level was an important predictor of postoperative THR. When stratifying preoperative TSH levels, the frequencies of T4 replacement in each TSH quartile varied, being more frequent with increasing presurgical TSH levels (p = 0.029). The preoperative cutoff that maximized sensitivity and specificity for the development of hypothyroidism was 1.21 μIU/mL.

Conclusion Our results demonstrated a significant frequency of postlobectomy THR. Higher preoperative TSH is a strong risk factor for postsurgical hypothyroidism, and even lower preoperative levels within the normal references do not exclude the risk of thyroid hormone use after thyroid lobectomy.

Keywords

thyroidectomy - hypothyroidism - thyroid hormones


Publikationsverlauf

Eingereicht: 24. September 2022

Angenommen: 18. Juni 2023

Artikel online veröffentlicht:
15. April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

Bibliographical Record
Ramona Paula Fernandes Reckziegel, Lenara Golbert, Erika Laurini de Souza Meyer. Role of Preoperative Thyroid-Stimulating Hormone Levels in the Prediction of Thyroid Hormone Replacement after Hemithyroidectomy. Int Arch Otorhinolaryngol 2025; 29: s00451801852.
DOI: 10.1055/s-0045-1801852
 

  • References

  • 1 Haugen BR, Alexander EK, Bible KC. et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2016; 26 (01) 1-133
    CrossrefPubMedSuche in Google Scholar
  • 2 Patel KN, Yip L, Lubitz CC. et al. The American Association of Endocrine Surgeons guidelines for the definitive surgical management of thyroid disease in adults. Ann Surg 2020; 271 (03) e21 –e93
    CrossrefPubMedSuche in Google Scholar
  • 3 Kandil E, Noureldine SI, Abbas A, Tufano RP. The impact of surgical volume on patient outcomes following thyroid surgery. Surgery 2013; 154 (06) 1346-1352 , discussion 1352–1353
    PubMedSuche in Google Scholar
  • 4 Ahn D, Lee GJ, Sohn JH. Levothyroxine supplementation following hemithyroidectomy: incidence, risk factors, and characteristics. Ann Surg Oncol 2019; 26 (13) 4405-4413
    PubMedSuche in Google Scholar
  • 5 Wilson M, Patel A, Goldner W, Baker J, Sayed Z, Fingeret AL. Postoperative thyroid hormone supplementation rates following thyroid lobectomy. Am J Surg 2021; 221 (04) 804-808
    PubMedSuche in Google Scholar
  • 6 Verloop H, Louwerens M, Schoones JW, Kievit J, Smit JW, Dekkers OM. Risk of hypothyroidism following hemithyroidectomy: systematic review and meta-analysis of prognostic studies. J Clin Endocrinol Metab 2012; 97 (07) 2243-2255
    CrossrefPubMedSuche in Google Scholar
  • 7 Koh YW, Lee SW, Choi EC. et al. Prediction of hypothyroidism after hemithyroidectomy: a biochemical and pathological analysis. Eur Arch Otorhinolaryngol 2008; 265 (04) 453-457
    PubMedSuche in Google Scholar
  • 8 Ahn D, Sohn JH, Jeon JH. Hypothyroidism Following Hemithyroidectomy: Incidence, Risk Factors, and Clinical Characteristics. J Clin Endocrinol Metab 2016; 101 (04) 1429-1436
    CrossrefPubMedSuche in Google Scholar
  • 9 Meyer C, Anderson D, Dong Z, Riddick JB, Elrod M, Ayala M. Prediction of thyroid hormone replacement following thyroid lobectomy: a long-term retrospective study. OTO Open 2021; 5 (01) X21992001
    Suche in Google Scholar
  • 10 Lee DY, Seok J, Jeong WJ, Ahn SH. Prediction of thyroid hormone supplementation after thyroid lobectomy. J Surg Res 2015; 193 (01) 273-278
    CrossrefPubMedSuche in Google Scholar
  • 11 Said M, Chiu V, Haigh PI. Hypothyroidism after hemithyroidectomy. World J Surg 2013; 37 (12) 2839-2844
    CrossrefPubMedSuche in Google Scholar
  • 12 Schumm MA, Lechner MG, Shu ML. et al. Frequency of thyroid hormone replacement after lobectomy for differentiated thyroid cancer. Endocr Pract 2021; 27 (07) 691-697
    PubMedSuche in Google Scholar
  • 13 Park S, Jeon MJ, Song E. et al. Clinical Features of Early and Late Postoperative Hypothyroidism After Lobectomy. J Clin Endocrinol Metab 2017; 102 (04) 1317-1324
    CrossrefPubMedSuche in Google Scholar
  • 14 Buehler LA, Madhun NZ, Bena J, Nasr C, Scharpf J, Zhou K. Hormonal outcomes following hemithyroidectomy. Otolaryngol Head Neck Surg 2021; 164 (05) 1011-1018
    PubMedSuche in Google Scholar
  • 15 Cox C, Bosley M, Southerland LB. et al. Lobectomy for treatment of differentiated thyroid cancer: can patients avoid postoperative thyroid hormone supplementation and be compliant with the American Thyroid Association guidelines?. Surgery 2018; 163 (01) 75-80
    PubMedSuche in Google Scholar
  • 16 Barranco H, Fazendin J, Lindeman B, Chen H, Ramonell KM. Thyroid hormone replacement following lobectomy: Long-term institutional analysis 15 years after surgery. Surgery 2023; 173 (01) 189-192
    PubMedSuche in Google Scholar
  • 17 Li Z, Qiu Y, Fei Y, Xing Z, Zhu J, Su A. Prevalence of and risk factors for hypothyroidism after hemithyroidectomy: a systematic review and meta-analysis. Endocrine 2020; 70 (02) 243-255
    PubMedSuche in Google Scholar
  • 18 Tomoda C, Ito Y, Kobayashi K, Miya A, Miyauchi A. Subclinical hypothyroidism following hemithyroidectomy: a simple risk-scoring system using age and preoperative thyrotropin level. ORL J Otorhinolaryngol Relat Spec 2011; 73 (02) 68-71
    PubMedSuche in Google Scholar
  • 19 Cao Z, Liu R, Wu M, Xu X, Liu Z. Risk factors for thyroid hormone replacement therapy after hemithyroidectomy and development of a predictive nomogram. Endocrine 2022; 76 (01) 85-94
    PubMedSuche in Google Scholar
  • 20 Beisa V, Kazanavicius D, Skrebunas A, Simutis G, Ivaska J, Strupas K. Prospective analysis of risk for hypothyroidism after hemithyroidectomy. Int J Endocrinol 2015; 2015: 313971
    PubMedSuche in Google Scholar