Treatment of Patients with Toxic Multinodular Goiter
Abstract
The medical records of 253 patients evaluated for toxic multinodular goiter from 1975 through 1993 were reviewed to determine treatment trends, success, and complications. Of the 235 (93%) treated, 174 (74%) received surgical treatment and 61 (26%) received radioiodine (131I) treatment. Three months after initial treatment, 82% of surgically treated patients became euthyroid or hypothyroid compared with 21% of the 131I group. Among the 131I-treated patients, 20% required a second treatment, whereas none needed further treatment in the surgical group. At 2 years, the estimated probability of success was similar. The probability of post-treatment hypothyroidism was significantly higher for surgically treated patients, which is expected.
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For patients with TMNG who receive RAI therapy, the response is 50%-60% by 3 months and 80% by 6 months.
“For patients with TMNG who receive RAI therapy, the response is 50%-60% by 3 months and 80% by 6 months (246,248,249).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [246]
For patients with TMNG, the risk of treatment failure or need for repeat treatment is <1% following near-total/total thyroidectomy, compared with a 20% risk of the need for retreatment following RAI therapy.
“For patients with TMNG, the risk of treatment failure or need for repeat treatment is <1% following near-total and/ total thyroidectomy (246,247), compared with a 20% risk of the need for retreatment following RAI therapy (246,248).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [246]
Euthyroidism is achieved within days after surgery for TMNG.
“Euthyroidism is achieved within days after surgery (246,247).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [246]
Risk of persistent or recurrent hyperthyroidism after RAI for TMNG or TA ranged from 0% to 30%, depending on the series.
“Risk of persistent or recurrent hyperthyroidism ranged from 0% to 30%, depending on the series (246-248,257).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [246]
RAI therapy for TMNG results in resolution of hyperthyroidism in approximately 55% of patients at 3 months and 80% at 6 months, with an average failure rate of 15%.
“RAI therapy for TMNG results in resolution of hyperthyroidism in approximately 55% of patients at 3 months and 80% of patients at 6 months, with an average failure rate of 15% (246-248).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [246]
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- Authors
- ERICKSON, D., GHARIB, H., LI, H., & VAN HEERDEN, J. A.
- Affiliations
- Mayo Clinic (US)
- Venue
- Thyroid
- Publisher
- SAGE Publications
- Published
- 1998-04
- Volume
- 8
- Issue
- 4
- Pages
- 277-282
- ISSN
- 1050-7256 (ISSN-L)
- 1557-9077
- OpenAlex
- W2036317296
- Cited by
- 64
- References
- 21
- Citations by year
- 2024: 4 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 4 · 2017: 4 · 2016: 3 · 2015: 1 · 2014: 1 · 2013: 2 · 2012: 3
- FWCI
- 2.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Thyroid (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Keywords
- toxic multinodular goiter, Graves' disease, surgical treatment, radioiodine therapy, iodine-131, treatment outcomes, post-treatment hypothyroidism, recurrence, treatment complications
- MeSH terms
- Adult, Female, Follow-Up Studies, Goiter, Nodular, Humans, Iodine Radioisotopes, Male, Recurrence, Thyroid Gland, Thyroidectomy, Thyrotoxicosis
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