TSH suppression may not benefit intermediate/high-risk DTC

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Takeaway

  • Analysis of a multicenter database suggests that suppression of thyrotropin/thyroid-stimulating hormone (TSH) is not associated with improved PFS in patients with intermediate- or high-risk differentiated thyroid cancer (DTC).

Why this matters

  • There are conflicting data on the association between TSH suppression and patient outcomes.

Key results

  • 33.8% of patients experienced disease progression, and 3.9% died.
  • TSH suppression was not significantly associated with PFS at 1.5 years (P=.41), 3 years (P=.51), or 5 years (P=.64).
  • TSH suppression was not significantly associated with OS at 1.5 years (P=.69) or 5 years (P=.52).
  • Nonsuppressed TSH was associated with longer OS at 3 years (moderately suppressed/low-normal vs suppressed [HR, 0.10; P=.03]; low-normal/elevated vs suppressed [HR, 0.10; P=.03]).

Study design

  • 867 patients with intermediate- or high-risk DTC treated with total thyroidectomy and radioactive iodine as well as levothyroxine therapy for TSH suppression were analyzed for associations between levels of TSH suppression and PFS.
  • Funding: NIH.

Limitations

  • Retrospective study.