BACKGROUND: The aim of the study was to identify the factors that are predictive
of recurrence after thyroid lobectomy for unilateral non-toxic thyroid goiter in
an endemic region through a multivariate analysis.
METHODS: Two hundred sixty-eight consecutive patients who underwent thyroid
lobectomy and who were evaluated by the same endocrinologist were included.
Univariate and multivariate analysis analyzed the relationship between sex, age,
preoperative thyroid-stimulating hormone, duration of disease, duration of
levothyroxine (LT4) preoperative therapy, cytologic results, histologic results,
resected thyroid weight, numbers and diameters of thyroid nodules, morphologic
alterations of the remnant lobe, follow-up length, postoperative LT4 therapy,
ultrasonographic evidence of recurrence, and reoperation.
RESULTS: The incidence of recurrence was 33.9% (91/268 patients) after a mean
follow-up time of 79.9 months (range, 12-251 months), female sex ( P = .016),
multiple nodules ( P = .017), and lack of postoperative LT4 therapy ( P = .0009)
were predictive factors of recurrence. Reoperation was performed in 20 patients
(7.4%); factors that were predictive of reoperation were the presence of multiple
nodules ( P = .008), resected thyroid weight ( P = .00006), and lack of
postoperative hormonal therapy ( P = .0005).
CONCLUSIONS: Thyroid lobectomy for unilateral non-toxic goiter, when combined
with suppressive or substitutive thyroxin therapy, resulted in a low rate of
recurrence and reoperation in an endemic area.
- Recurent goiter