TSH Cutoffs and Recurrence Risk in Differentiated Thyroid Carcinomas: A Systematic Review and Meta-Analysis
Authors' conclusion
The degree of TSH suppression did not affect the overall risk of DTC recurrence. However, TSH suppression may be beneficial in reducing the recurrence risk in high-risk patients with distant metastases.
Study context
- Population
- Patients with differentiated thyroid cancer (DTC), stratified by American Thyroid Association (ATA) risk of recurrence; studies reporting recurrence rate of DTC by TSH cutoffs (Ovid-Medline, EMBASE, Cochrane through March 2024)2 RCTs and 7 observational studies
- Participants
- 5,320 patients
- Comparison
- Recurrence risk by TSH cutoffs
- Outcome
- Risk of DTC recurrence according to TSH cutoffs (0.1, 0.5 and 2.0 mIU/L)
Methodological detailsincludes randomised controlled trials and observational studies, subgroup analysis by ATA risk of recurrence, leave-one-out meta-analysis
- Includes randomised controlled trials and observational studies
- Subgroup analysis by ATA risk of recurrence
- Leave-one-out meta-analysis
Pooled result
As reported in the abstract
Pooled recurrence risk by TSH cutoff
Overall recurrence rate
18%
Further pooled results
Subgroups by ATA risk of recurrence (low- and high-risk DTC)
- Pooled hazard ratios (HRs) did not differ according to TSH levels
- Subgroup analysis
Recurrence risk, serum TSH ≥0.1 mIU/L
- HR
- 2.27 (95% CI 1.29-3.99)
- Leave-one-out meta-analysis after removing the study that significantly influenced the analysis
Recurrence risk, TSH ≥2.0 mIU/L
- HR
- 1.36 (95% CI 1.001-1.84)
- Leave-one-out meta-analysis after removing the study that significantly influenced the analysis
Recurrence risk in patients with distant metastases, TSH ≥0.1 mIU/L
- HR
- 3.3 (95% CI 1.53-7.10)
Original publication
TSH Cutoffs and Recurrence Risk in Differentiated Thyroid Carcinomas: A Systematic Review and Meta-Analysis. J Clin Endocrinol Metab. Published 14 August 2025. doi:10.
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