Durable Remission Occurs More Frequently for Graves Disease Patients Treated Surgically

Engelbrecht-Wiggans EA, Carlisle K, Yunasan E, et al. Long-Term Retreatment Outcomes After Definitive Management of Graves' Disease with Radioactive Iodine Versus Surgery. Surgery. 2024, in press.

This single-institution, retrospective cohort study reported outcomes of radioactive iodine (RAI) and thyroidectomy in patients with Graves disease. Outcomes of interest were rates of definitive retreatment (RAI or surgery) after the index definitive treatment event and rates of retreatment (antithyroid drugs or second definitive treatment).

Index treatments were thyroidectomy for 72 patients and RAI for 104 patients; follow up was obtained at a median of 3.6 years. Complete remission was confirmed at 6 months in 68.8% of RAI patients and 98.6% of thyroidectomy patients. Recurrent disease occurred in 19% of RAI patients who had initial remission at 6 months.

Significant complications (bleeding hypocalcemia, nerve injury) occurred in 20 of the 72 patients treated surgically.

The authors concluded that durable remission occurs more frequently in patients treated surgically.