Malignant and Benign Neoplasms of the Thyroid in Patients Treated for Hyperthyroidism: A Report of the Cooperative Thyrotoxicosis Therapy Follow-up Study

Dobyns, Brown M.; Sheline, Glenn E.; Workman, Joseph; Tompkins, Edythalena A.; McConahey, William M.; Becker, David V.

doi:10.1210/jcem-38-6-976

Cited by 358 publications

(178 citation statements)

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“…In our base-case analysis we assumed there was no risk of radiation-induced thyroid cancer. Three reports (60,64,65) have found an increased relative risk while others (43,61,63) have not. Furthermore, some of them (60,63) have noted a small increased risk of other cancers.…”

Section: Discussionmentioning

confidence: 95%

“…(11,33,34,(36)(37)(38) 0.185 0.064 -0.306 0.99 Recurrent hyperthyroidism (11,31,(33)(34)(35)(36)38) 0.014 0 -0.045 95 Radio-induced thyroid cancer (31,43,61,63) 0.000 (0-0.008) § 0.83 Surgery Dysphonia (12,15,32,50) 0.030 0.015 -0.040 0.98 Hypothyroidism (11-15, 32, 39) 0.040 0.020 -0.054 0.99 * Quality-adjustment factors reflect the relative desirability of each health state or event. They usually result from expert judgment, values from the literature or values from measurements on a sample of subjects (40).…”

Section: Resource Usementioning

confidence: 99%

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Managing toxic thyroid adenoma: a cost-effectiveness analysis

2002

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Objective: To examine the cost-effectiveness of therapeutic strategies for patients with toxic thyroid adenoma. Design: A decision analytic model was used to examine strategies, including thyroid lobectomy after a 3-month course of antithyroid drugs (ATDs), radioactive iodine (RAI), and lifelong ATDs followed by either RAI (ATD-RAI) or surgery (ATD-surgery) in patients suffering severe drug reactions. Methods: Outcomes were measured in quality-adjusted life years. Data on the prevalence of co-incident thyroid cancer, complications and treatment efficacies were derived from a systematic review of the literature (1966 -2000). Costs were examined from the health care system perspective. Costs and effectiveness were examined at their present values. Discounting (3% per year), variations of major cost components, and every variable for which disagreements exist among studies or expert opinion were examined by sensitivity analyses. Results: For a 40-year-old woman, surgery was both the most effective and the least costly strategy (e1391),while ATD-RAI cost the most (e5760). RAI was more effective than surgery if surgical mortality exceeded 0.6% (base-case 0.001%). RAI become less costly for women of more than 72 years (more than 66 in discounted analyses). For women of 85, ATD-RAI may be more effective than RAI and have an inexpensive marginal cost-effectiveness ratio (e4975) if lifelong follow-up results in no decrement in quality of life. Conclusions: Age, surgical mortality, therapeutic costs and patient preference must all be considered in choosing an appropriate therapy.

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Section: Discussionmentioning

confidence: 95%

Section: Resource Usementioning

confidence: 99%

Managing toxic thyroid adenoma: a cost-effectiveness analysis

2002

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“…This risk appeared to be higher in patients given lower doses of radioiodine. In the same study, thyroid carcinoma was no more common in radioiodine-treated patients than those treated with ATD or thyroidectomy (70). In a recent report, which is an update of reference 70, Ron et al (71) observed, over a mean follow-up period that extended to 21 years, no increase in overall cancer mortality after iodine-131 therapy compared with standard US mortality rates.…”

Section: Overall Toxicity (%)mentioning

confidence: 86%

“…They concluded that, to ensure ablation of thyroid tissue, doses over 270 Gy (300 mCi/g) are needed, especially when the thyroid is large. Another consequence seems to be the increased incidence of benign thyroid adenomas (70). This risk appeared to be higher in patients given lower doses of radioiodine.…”

Section: Overall Toxicity (%)mentioning

confidence: 99%

Treatment of juvenile Graves' disease and its ophthalmic complication: the 'European way'

Krassas¹

2004

European Journal of Endocrinology

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“…Radioiodine therapy is currently the treatment of choice for most adults with Graves' disease and has been successfully employed to treat childhood Graves' disease in several institutions. There are some articles suggesting that radioiodine treatment for Graves' disease 1) increases the risk of benign thyroid nodules [11], 2) increases the risk of hyperparathyroidism [12], and 3) slightly increases the risk of more aggressive thyroid cancer [13]. Radioiodine treatment has become popular in recent years in Japan, however, the strict safety rules and patients' radiation phobia prevent its widespread adoption [14].…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Graves' Disease -10-year Prospective Trial at a Single Institution-

et al. 2008

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Abstract. The extent of thyroidectomy in Graves' disease is still controversial. In our institution, long term euthyroidism without thyroxine replacement therapy has been aimed and, thus, subtotal thyroidectomy has been employed. We prospectively studied whether the surgical outcome was improved by a strategy of leaving smaller thyroid remnants. Between 1989 and 1998, 1897 patients with Graves' disease were treated by subtotal thyroidectomy and their thyroid function could be determined 2 to 3 years after thyroidectomy. The 10-year period was divided into 3 parts, '89-'91 (Period 1, n = 690), '92-'94 (Period 2, n = 587) and '95-'98 (Period 3, n = 620). Different maximum thyroid remnant sizes were prospectively established for each period: up to 7 g left in Period 1, up to 6 g in Period 2 and up to 5 g in Period 3. Thyroid function 2 to 3 years after thyroidectomy and the occurrence of surgical complications were compared among the three groups. The relapse rate for Period 1, Period 2, and Period 3 was 14.1%, 12.6%, and 10.9%, respectively, and the rate of euthyroidism decreased and rate of hypothyroidism increased from period to period. Surgical complications increased in Periods 2 and 3. For preventing relapse, the strategy of reducing the thyroid remnant is effective. Subtotal thyroidectomy leaving 3-4 g remnant tissue is a suitable surgical option for Graves' disease.

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Malignant and Benign Neoplasms of the Thyroid in Patients Treated for Hyperthyroidism: A Report of the Cooperative Thyrotoxicosis Therapy Follow-up Study

Cited by 358 publications

References 0 publications

Managing toxic thyroid adenoma: a cost-effectiveness analysis

Managing toxic thyroid adenoma: a cost-effectiveness analysis

Treatment of juvenile Graves' disease and its ophthalmic complication: the 'European way'

Surgical Management of Graves' Disease -10-year Prospective Trial at a Single Institution-

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