Graves' Disease: A Long-Term Quality-of-Life Follow Up of Patients Randomized to Treatment with Antithyroid Drugs, Radioiodine, or Surgery
Abstract
The effects of treatment modality for Graves' disease (GD) were studied with respect to long-term quality of life and present health status. A total of 179 patients with GD were randomized during the period 1983-1990 for treatment with antithyroid drugs, radioiodine, or surgery. A 36-item Short Form Health Status Survey questionnaire and specific questions for GD were sent to patients 14-21 years after randomization. Present medical records, and clinical and laboratory status were recorded. No major significant differences in quality of life among the three treatments were observed. Compared to a large Swedish reference group, all treatment groups had significantly lower scores for vitality (p < 0.05). The Mental Component Summary was lower for both the young medical, young surgical, and the older medical group (p < 0.05). Radioiodine-treated patients had a lower General Health score. Young medical patients (<35 years) had lower Mental Health scores (p < 0.05). There was also a strong trend, which barely met statistically significance, for older surgical and radioiodine groups for lower Mental Component Summary. GD patients have, compared with a large Swedish reference population, diminished vital and mental quality of life aspects even many years after treatment. The quality-of-life scores were not different among the three treatment modalities.
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Long-term quality of life following treatment for Graves' disease was found to be the same in patients randomly allocated to one of the three treatment options.
“The long-term quality of life (QoL) following treatment for GD was found to be the same in patients randomly allocated to one of the three treatment options (62).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [62]
Surgeons who perform more than 25 thyroid surgeries per year have superior patient clinical and economic outcomes compared to those who perform fewer; complication rates are 51% higher on average when surgery is performed by low-volume surgeons.
“Data show that surgeons who perform more than 25 thyroid surgeries per year have superior patient clinical and economic outcomes compared to those who perform fewer; complication rates are 51% higher on average when surgery is performed by low-volume surgeons (62,199,200).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [62]
Nonfunctioning or hypofunctioning nodules on a RAI scan may have a higher probability of being malignant.
“If a RAI scan is performed, any nonfunctioning or hypofunctioning nodules should be considered for fine-needle aspiration because they may have a higher probability of being malignant (62).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [62]
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- Authors
- Abraham-Nordling, M., Törring, O., Hamberger, B., Lundell, G., Tallstedt, L., Calissendorff, J., & Wallin, G.
- Affiliations
- Department of Surgery, Karolinska University Hospital, Solna, Sweden.
- Stockholm South General Hospital (SE)
- Karolinska University Hospital (SE)
- S:t Eriks Ögonsjukhus (SE)
- Venue
- Thyroid
- Publisher
- SAGE Publications
- Published
- 2005-11
- Volume
- 15
- Issue
- 11
- Pages
- 1279-1286
- ISSN
- 1050-7256 (ISSN-L)
- 1557-9077
- OpenAlex
- W2144059299
- Cited by
- 163
- References
- 34
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 8 · 2023: 10 · 2022: 10 · 2021: 16 · 2020: 9 · 2019: 10 · 2018: 14 · 2017: 5 · 2016: 8 · 2015: 8 · 2014: 3 · 2013: 6 · 2012: 11
- FWCI
- 2.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Thyroid (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Karolinska Institutet
- Vetenskapsrådet
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
- Keywords
- Graves' disease, quality of life, antithyroid drugs, radioiodine therapy, thyroidectomy, treatment comparison, long-term follow-up, vitality, mental health, health status
- MeSH terms
- Adult, Aging, Female, Follow-Up Studies, Graves Disease, Health, Humans, Iodine Radioisotopes, Male, Mental Health, Middle Aged, Quality of Life, Surveys and Questionnaires, Recurrence, Social Behavior, Sweden, Antithyroid Agents, Thyroidectomy, Thyrotropin
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