Predictive factors for recurrence after thyroid lobectomy for unilateral non-toxic goiter in an endemic area: results of a multivariate analysis.
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.
Bellantone
Rocco
R
Division of Endocrine Surgery, Catholic University, Largo A. Gemelli 8, 00168 Rome, Italy.
Lombardi
Celestino Pio
CP
Boscherini
Mauro
M
Raffaelli
Marco
M
Tondolo
Vincenzo
V
Alesina
Pier Francesco
PF
Corsello
Salvatore Maria
SM
Fintini
Danilo
D
Bossola
Maurizio
M
D000328:Adult; D005260:Female; D006043:Goiter, Endemic / Q000188:drug therapy / Q000601:surgery*; D006728:Hormones / Q000627:therapeutic use; D006801:Humans; D007558:Italy; D008297:Male; D015999:Multivariate Analysis; D011183:Postoperative Complications; D011379:Prognosis; D012008:Recurrence; D012086:Reoperation; D012307:Risk Factors; D013965:Thyroidectomy; D013974:Thyroxine / Q000627:therapeutic use
D006728:Hormones; D013974:Thyroxine