EFFECTIVENESS OF PROPHYLACTIC THERAPY ON GOITER RECURRENCE IN AN AREAWITH LOW IODINE INTAKE - A SONOGRAPHIC FOLLOW-UP-STUDY

There is no agreement as to whether or not drug treatment after surger y for nodular goiter is effective in preventing recurrence of goiter. Data about recurrences in areas of marginally low iodine intake (like Germany) vary widely. Therefore, we performed a retrospective study in 104 patients who had been treated surgically because of benign uninod ular or multinodular goiter. The mean follow-up period was 6.4 years ( minimal 1 year) with at least three examinations. Thyroid ultrasound w ith volumetric analysis was recorded in each patient. Thirty-two patie nts did not receive any prophylaxis, 50 patients were treated with L-t hyroxine, 17 patients with a combination of L-thyroxine and iodine and 5 patients with iodine alone. Recurrence of goiter was documented in 28.0% of the untreated patients and in 8.9% of the patients on prophyl axis (P < 0.05). The mean increase of thyroid volume was 7.3 ml versus 3.1 ml in patients without versus with prophylactic drug treatment (n ot significant). No significant correlation was found between the incr ease of thyroid volume and age of the patients, follow-up time, or int ial thyroid volume, respectively. These data clearly demonstrate the e ffectiveness of prophylactic drug therapy to prevent recurrence of goi ter after thyroid surgery in an iodine-deficient area.