Levothyroxine supplementation after hemithyroidectomy in patients with low-risk differentiated thyroid cancer: risk factors and withdrawal strategy

作者：Jin Seok Lee, Eun Ju Ha, Ho Jung Jeong, Soo Young Kim, Hyeung Kyoo Kim · 发表于：Frontiers in Endocrinology · 年份：2025 · DOI：10.3389/fendo.2025.1627721 · 被引用次数：1 · 研究领域：Thyroid and Parathyroid Surgery、Thyroid Cancer Diagnosis and Treatment、Thyroid Disorders and Treatments

Background The American Thyroid Association guidelines recommend maintaining thyroid-stimulating hormone (TSH) levels < 2 mIU/L postoperatively in low-risk patients. Patients with low-risk differentiated thyroid cancer, defined as intrathyroidal tumors without vascular invasion, aggressive histology, or metastasis according to ATA criteria, were included. Many patients who undergo hemithyroidectomy often maintain normal TSH levels, i.e., a euthyroid status, without taking levothyroxine after surgery. However, some patients continue to receive levothyroxine supplementation post-surgery. In this study, we analyzed the risk factors and predictors of levothyroxine withdrawal. Methods The medical records of 132 patients who underwent hemithyroidectomy for thyroid cancer at Ajou University Hospital between February 2016 and February 2018 were reviewed. The medical records included data on demographics, type of operation, pathological findings, pre- and postoperative changes in TSH levels, levothyroxine dosage and discontinuation timing, and pre- to postoperative changes in thyroid gland volume. All patients were started on a fixed dose of levothyroxine immediately after surgery, which was subsequently tapered and withdrawn based on the TSH levels. Results Among 132 patients who underwent hemithyroidectomy, 67 (51%) eventually withdrew from postoperative levothyroxine. Of the many dependent variables, multivariate analysis revealed the statistical significance of preoperative...