[Analysis of the factors associated with recurrence of post-thyroidectomy goiter].

Abstract

The factors associated with post-thyroidectomy goiter recurrence in benign thyroid disease are not clearly defined, especially prophylactic thyroxine treatment. PURPOSE--To determine the prevalence, characteristics and associated factors of recurrence of goiter post-thyroidectomy in patients submitted to surgery for benign disease. METHODS--Sixty-six patients, 53 female and 13 male (mean age = 51 yrs., range 20-82 yrs.), previously (5.6 +/- 6.1 yrs.) submitted to thyroidectomy (lobectomy, n = 50; nodulectomy, n = 5; subtotal thyroidectomy, n = 11) for benign thyroid disease were included. Measurements of T3, T4, TSH, thyroid microsomal autoantibody titers and thyroid ultrasonography were performed at the time of the study. Recurrence of goiter post-thyroidectomy was defined on ultrasonography as the presence of residual thyroid volume > 20mL and/or new nodules > 0.5mL not detected at surgery. RESULTS--Seven patients (10%) developed recurrence of goiter. The post-operative follow-up period was longer in the recurrence group and there was no difference between the two groups as to age, sex, familial history of thyropathy and preoperative goiter diagnosis. In multiple regression analysis only the following post-operative period was significantly associated to goiter recurrence (beta = 0.02; R2 = 0.16; p < 0.05) and influenced the goiter recurrence rate by 14%. Familial history of thyropathy, thyroxine treatment in non-supressible doses after thyroidectomy and seric T4 and TSH levels did not influence the recurrence. CONCLUSION--Recurrence of goiter post-thyroidectomy occurs in a small number of patients and is related to longer post-operative follow-up time. Thyroxine treatment in non-supressible doses after surgery is not related to goiter recurrence prevention.