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Graves’ orbitopathy development in thyroid cancer patients: a 16-year nationwide cohort study in South Korea

Eye (2024)Cite this article

Subjects

Abstract

Background/objectives

We aimed to investigate the prevalence, risk factors, and prognosis of Graves’ orbitopathy (GO) in patients with thyroid cancer without a history of hyperthyroidism.

Subjects/methods

This retrospective cohort study analysed a sample from the Korean National Health Insurance Service database, which included 1,137,861 subjects from 2002 through 2019. Patients diagnosed with thyroid cancer, without a history of hyperthyroidism, were identified according to the Korean Standard Classification of Disease codes. The study compared the type of surgery, dose of radioactive iodine (RAI), and daily average thyroid hormone dose between patients who developed GO after being diagnosed with thyroid cancer and those who did not develop GO. We analysed the course of GO and the type of treatment.

Results

A total of 8499 cancer patients without a history of hyperthyroidism were identified, among whom 7836 underwent thyroidectomy. Of those who underwent thyroidectomy, 12 developed GO postoperatively. Among the 663 patients who did not undergo thyroidectomy, none developed GO. The prevalence of GO among thyroid cancer patients was 0.14%. The GO group received a significantly higher total RAI dose than the non-GO group (p = 0.036). There were no significant differences in sex, age, type of surgery, rate of RAI treatment, or average thyroid hormone dose between the two groups. One of the 12 patients who developed GO required intravenous steroids.

Conclusions

Although GO rarely develops in thyroid cancer patients without coexisting hyperthyroidism, the total RAI dose may increase its risk. Further research would help clarify GO’s association with thyroid cancer.

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Data availability

Datasets used and analysed during the current study are available from the corresponding author upon reasonable request.

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Funding

Funding

This research was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (NRF-2021R1A2C1011351) and the Chung-Ang University Research Grants in 2023. The funding organisation had no role in the design or conduct of this research.

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Author notes

  1. These authors contributed equally: Minjeong Kim, Jooyoung Lee.

Authors and Affiliations

  1. Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea

    Minjeong Kim & Jeong Kyu Lee

  2. Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea

    Jooyoung Lee, Yu Been Hwang & Jinmo Kang

  3. Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea

    Hwa Young Ahn

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  1. Minjeong Kim
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Contributions

MK was responsible for writing the article. JL was responsible for designing the protocol and analysing the data. YBH contributed to data extraction and data analysis. JK contributed to data extraction. HYA was responsible for designing the protocol and interpreting the results. JKL was responsible for designing the protocol, interpreting results, and revising the article.

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Correspondence to Hwa Young Ahn or Jeong Kyu Lee.

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Kim, M., Lee, J., Hwang, Y.B. et al. Graves’ orbitopathy development in thyroid cancer patients: a 16-year nationwide cohort study in South Korea. Eye (2024). https://doi.org/10.1038/s41433-024-03197-9

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