The Recovery of Thyroid Function in Low-Risk Papillary Thyroid Cancer After Lobectomy: A 3-Year Follow-Up Study

Dou, Yi; Chen, Yingji; Hu, Daixing; Su, Xinliang

doi:10.3389/fendo.2020.619841

Cited by 13 publications

(8 citation statements)

References 33 publications

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“…In this study, 132 out of 199 CPA patients were lost to follow-up, the follow-up rate was 33.2% (67/199), lower than that of other chronic diseases ( 18 , 19 ). There was no significant difference in the severity of CPA during hospitalization and the antibiotic regimen after discharge between patients receiving regular follow-up and those lost to follow-up.…”

Section: Discussionmentioning

confidence: 64%

Loss to follow-up associated factors in patients with chronic pulmonary aspergillosis and its impact on the disease prognosis

et al. 2022

Front. Public Health

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ObjectivePulmonary aspergillosis is a rare but challenging pulmonary disease. The conditions of patients with chronic pulmonary aspergillosis (CPA) can be even more complicated. The mortality rate of CPA remains high, and the prognostic factors are not well established due to a high proportion of loss to follow-up. In this study, we aim to explore factors associated with loss to follow-up in CPA patients and their impact on the disease prognosis after withdrawing anti-fungal treatments.MethodsPatients with confirmed CPA, who were admitted to the Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Guangzhou Medical University from March 2017 to November 2019, were enrolled in this prospective study. The enrolled patients were followed up for 6 months after discharge. For loss to follow-up patients, the reasons for loss to follow-up and their prognosis after withdrawing anti-fungal treatments during loss to follow-up were recorded by telephone communication. Multivariate logistic regression analysis was performed to determine factors associated with loss to follow-up.ResultsThe 199 out of 298 screened patients were included in the study. Except for 67 cases with regular follow-up, the rest 132 cases were lost to follow-up. Factors, including age > 60 years (OR = 2.036, P = 0.03), monthly income ≤ $583 (OR = 5.568, P = 0.0001), education ≤ 6 years (OR = 7.474, P = 0.0001), and non-local residence (OR = 5.893, P = 0.0001) were associated with the loss to follow-up according to multivariate logistic regression analysis. The most common reasons for loss to follow-up were economic factors and clinic visit distance. The overall case fatality rate (CFR) within 180 days in patients with regular follow-up and patients who stopped anti-fungal treatment during the loss to follow-up was 0% and 19.65%, respectively.ConclusionThe proportion of loss to follow-up in CPA patients remained high. Age (>60 years), poor financial status, low education, and non-local residence were the key factors associated with the loss to follow-up in this study. Our study reveals the need to optimize the follow-up procedures and improve the patients understanding about the benefits and limitations of follow-up to reduce the CFR.

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Section: Discussionmentioning

confidence: 64%

Loss to follow-up associated factors in patients with chronic pulmonary aspergillosis and its impact on the disease prognosis

et al. 2022

Front. Public Health

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“…Nevertheless, mild deterioration of HR-QoL still occurs in TL patients, which subsequently recover after 1–2 years [ 13 20 21 ]. While most maintain adequate thyroid function, TL patients have a variety of thyroid hormone levels, with 26% requiring lifelong LT4 treatment [ 22 ]. Each patient’s remaining thyroid function can also fluctuate at different postoperative time points; Bae et al [ 23 ] showed that TSH levels were at their highest at 3–6 months after TL, as the percentage of patients with TSH level >2 mIU/L decreased from 82.3% at postoperative 3–6 months to 59.9% after 2 years of surgery.…”

Section: Discussionmentioning

confidence: 99%

Effect of thyroid-stimulating hormone suppression on quality of life in thyroid lobectomy patients: interim analysis of a multicenter, randomized controlled trial in low- to intermediate-risk thyroid cancer patients (MASTER study)

Lee,

Ku,

Kim

et al. 2024

Ann Surg Treat Res

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Purpose Current clinical practices favor less or no thyroid-stimulating hormone (TSH) suppression for low- to intermediate-risk thyroid cancer patients who receive thyroid lobectomy. The association of TSH suppression on health-related quality of life (HR-QoL) in patients after thyroid lobectomy is not well studied. This study aimed to evaluate the effect of TSH suppression on patient HR-QoL after thyroid lobectomy. Methods This study included patients enrolled in an ongoing, multicenter, randomized controlled study investigating the effects of TSH suppression. Patients were randomized to either the low-TSH group (TSH target range, 0.3–1.99 µIU/mL) or the high-TSH group (TSH target range, 2.0–7.99 µIU/mL). The HR-QoL, hyperthyroidism symptom, and depression symptom questionnaires performed preoperatively and 2 weeks and 3 months postoperatively were evaluated. Results Total of 669 patients (low-TSH group, 340; high-TSH group, 329) were included. Although total HR-QoL score changes were not different between the 2 groups, the high-TSH group had a significantly higher score in the physical domain at postoperative 3 months (P = 0.046). The 2 groups did not have significant differences in hyperthyroidism and depression scores. Conclusion In the short-term postoperative period, the physical HR-QoL scores in thyroid lobectomy patients were better when they did not receive TSH suppression. This study suggests the importance of considering HR-QoL when setting TSH suppression targets in thyroid lobectomy patients.

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“…We further found no significant difference in the probability of pCLN- between the left and right lobes. The left and right lobes of the thyroid gland were not completely symmetrical, but the right lobe was generally larger ( 40 ).…”

Section: Discussionmentioning

confidence: 99%

Prediction Model of Pathologic Central Lymph Node Negativity in cN0 Papillary Thyroid Carcinoma

Shu

Tang

et al. 2021

Front. Oncol.

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BackgroundMost patients with papillary thyroid carcinoma (PTC) have an excellent prognosis. Although central lymph node invasion is frequent, management via central lymph node dissection (CLND) remains controversial. The present study retrospectively investigated independent predictors of pathologic central lymph node negativity (pCLN-) and established a prediction model for pCLN- in clinical lymph node negativity (cN0) PTC.MethodsA total of 2,687 patients underwent thyroid surgery for cN0 PTC from 2013 to 2018 at the First Affiliated Hospital of Chongqing Medical University, and lobectomy plus ipsilateral CLND was the basic surgical extent. Clinicopathological characteristics were reviewed and analyzed. Univariate and multivariate analyses were performed to identify factors related to pCLN-. A prediction model was established based on the results of multivariate analyses.ResultsThe pCLN- rate was 51.5% (1,383/2,687). Multivariate analysis revealed that sex, age, thyroid stimulating hormone (TSH), size, location, laterality, unifocality and extrathyroidal extension negativity (ETE-) were independent predictors of pCLN-. The nomogram showed good discriminative ability (C-index: 0.784 and 0.787 in derivation and validation groups, respectively) and was well calibrated. We quantified the clinical usefulness of the nomogram by decision curve analysis. The median length of follow-up was 30 (range 12– 83) months, and 190 cases were lost, with a follow-up rate of 92.9% (2,497/2,687). Of the 2,687 patients included, 21 (0.8%) experienced recurrence.ConclusionThis nomogram, which integrates available preoperative clinicopathological features and intraoperative frozen biopsy outcomes, is a reliable tool with high accuracy to predict pCLN- in cN0 PTC.

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The Recovery of Thyroid Function in Low-Risk Papillary Thyroid Cancer After Lobectomy: A 3-Year Follow-Up Study

Cited by 13 publications

References 33 publications

Loss to follow-up associated factors in patients with chronic pulmonary aspergillosis and its impact on the disease prognosis

Loss to follow-up associated factors in patients with chronic pulmonary aspergillosis and its impact on the disease prognosis

Effect of thyroid-stimulating hormone suppression on quality of life in thyroid lobectomy patients: interim analysis of a multicenter, randomized controlled trial in low- to intermediate-risk thyroid cancer patients (MASTER study)

Prediction Model of Pathologic Central Lymph Node Negativity in cN0 Papillary Thyroid Carcinoma

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