Referral Trends for Surgical Management of Graves' Disease.

Referral Trends for Surgical Management of Graves' Disease.

Thyroid. 2017 Jul 12;:

Authors: Swegal WC, Chang SS, Singer MC

Abstract
BACKGROUND: Treatment algorithms for Graves' disease (GD) differ internationally and frequency of referral for surgical intervention varies markedly between areas. Given the potential benefits of thyroidectomy over radioactive iodine (RAI) and medical therapy, surgery may be underutilized. To better understand the approach of endocrinologists to GD, we assessed the rationale for consultation among patients referred for thyroidectomy to an endocrine surgery practice in the United States.
METHODS: This retrospective study reviewed all patients with a primary diagnosis of GD who underwent thyroidectomy by a single surgeon at a large academic medical center between March 2013 and October 2015. The primary factor assessed was the reason for which the patient was referred for surgery.
RESULTS: Of 52 patients, Graves' ophthalmopathy (GO) comprised 58% of primary referral reasons, followed by a desire to avoid RAI (13.5%) and goiter size (11.5%). Only 1 patient (1.9%) was referred for surgery due to failed RAI.
CONCLUSION: This study provides an in-depth assessment of referral patterns for surgery for GD in a single practice. In this series, GO was the most frequent indication for thyroidectomy over RAI in GD. The narrow range of reasons for referral suggests that some patients may not be fully aware of other possible benefits of thyroidectomy as a treatment option. Comprehensive patient education regarding treatment options should be given to all newly diagnosed GD patients to help them make a fully informed decision as to the best treatment option for them.

PMID: 28699420 [PubMed - as supplied by publisher]

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