Z Gastroenterol 2011; 49 - P481
DOI: 10.1055/s-0031-1285752

No Reason for Hypothyroidism. Five year follow-up results after combined thyroidectomy and Radio Ablation Therapy for differentiated thyroid cancer

N Emmanouilidis 1, WH Knapp 2, J Klempnauer 1, GFW Scheumann 1
  • 1Medizinische Hochschule Hannover, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Hannover, Germany
  • 2Medizinische Hochschule Hannover, Klinik für Nuklearmedizin, Hannover, Germany

Objective: The objective of this study was to compare rhTSH-stimulation versus the standard procedure of thyroid hormone withdrawal as a stimulus for primary radio ablation therapy after thyroidectomy for differentiated thyroid cancer in a clinical applicable setting.

Design: Therefore we compared the standard procedure of thyroidectomy followed by four weeks of L-T4 withdrawal and a conclusive ablative activity of 131Iodine with thyroidectomy followed by application of rhTSH and initiation of L-T4 medication and a subsequent radio ablation a few days after surgery. We evaluated parameters of quality-of-life during the initial treatment period as well as therapy efficacy at follow-up controls. We presumed that rhTSH stimulation should represent the most sophisticated strategy to sustain quality-of-life without any reduction in ablation efficacy.

Methods: N=44 patients were randomized either for surgery and rhTSH stimulation or surgery and L-T4-abstinence before the first application of radio-iodine. Ablation success was determined by neck ultra-sound and serum Thyroglobuline during follow-up controls. RhTSH-receivers were monitored for an average of 1200days (SD±250) and patients in L-T4-abstinence for an average of 1300days (SD±205). Each patient was interviewed regarding quality-of-life and both groups were compared for treatment efficacy and overall sick-leave time.

Results and conclusions: The combination of rhTSH and thyroidectomy into one hospitalization proved to be advantageous in regard to quality-of-life, sick-leave time and the patients job-performance while being equally efficacious and safe in comparison to the conventional therapy regimen – even at a long-term follow-up of ˜1000 days.