The Effect of Thyrotropin Suppression on Survival Outcomes in Patients with Differentiated Thyroid Cancer: A Systematic Review and Meta-Analysis
Authors' conclusion
TSH suppression in intermediate- and high-risk DTC may not improve survival outcomes but may increase the risk of secondary complications.
Study context
- Population
- Intermediate- and high-risk differentiated thyroid cancer (DTC) patients (≥18 years) treated as per regional guideline-based therapy, follow-up 5 years9 studies
- Comparison
- TSH suppression vs TSH nonsuppression
- Outcome
- (i) Composite of progression-free survival (PFS), disease-free survival (DFS) and relapse-free survival (RLFS); (ii) composite of disease-specific survival (DSS) and overall survival (OS)
Methodological detailsrandom-effects model
- Random-effects model
Pooled result
As reported in the abstract
Composite of PFS, DFS and RLFS; composite of DSS and OS
TSH suppression vs TSH nonsuppressionHazard ratio (95% CI)
PFS, DFS and RLFS composite; 7 studies (3,591 patients); I2 = 76%; not significantly different
0.75(0.48–1.17)
DSS and OS composite; 4 studies (3,616 patients); I2 = 88%; did not favor TSH suppression
0.69(0.31–1.52)
Safety
| Outcome | HR (95% CI) | |
|---|---|---|
| Composite of cardiac or skeletal adverse events | 1.82 (1.30–2.55) | |
| 0.20.5125Hazard ratio (log scale) |
- Composite of cardiac or skeletal adverse events: 2 studies (1,294 patients); I2 = 0%; significantly higher with TSH suppression
Original publication
The Effect of Thyrotropin Suppression on Survival Outcomes in Patients with Differentiated Thyroid Cancer: A Systematic Review and Meta-Analysis. Thyroid. Published 14 May 2024. doi:10.
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