Objective: Despite the expectation of normal life expectancy for thyroid cancer, there are concerns about the decreased quality of life (QoL). The present study investigated the potential risk factors of deterioration in QoL scores in thyroid cancer patients after thyroidectomy. Materials and methods: A total of 286 patients who were diagnosed with thyroid cancer after thyroidectomy were involved in this prospective, single-center, observational study from November 2018 to June 2019. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 was used to assess the QoL 3 months after thyroidectomy. We investigated the effects of demographics (age, gender, education, marital status, area of residence, and annual mean income), tumor characteristics (histology, clinical stage, presence of metastasis, surgery type, and radiotherapy), and neurological deficits induced by recurrent nerve or superior laryngeal injury on QoL. Results: The mean overall QoL in thyroid cancer survivors was 65.93 ±9.00 (on a scale of 0-100, where 100 was the best). Multivariate regression analysis confirmed that clinical stage (P < 0.010), surgery type (P < 0.001), histology (P < 0.001), neurological deficits (P < 0.001), and marital status (P < 0.001) were independent risk factors for decreased QoL 3 months after thyroidectomy. Conclusion: Our study indicated that clinical stage, surgery type, histology, neurological deficits, and marital status were independent risk factors for decreased QoL at 3 months after thyroidectomy. Further exploration and validation of these findings in larger prospective studies are warranted.
Background Increased reflux symptoms limited clinical application of proximal gastrectomy (PG) in the patients with early adenocarcinoma of esophagogastirc junction (AEG). The purpose of this study is to describe a method of modified double-tract reconstruction (DTR) after PG, and to evaluate the feasibility, safety, surgical outcomes, postoperative gut function and nutritional status post operation. Methods Prospective cohort data of 25 patients with early AEG who presented to a single tertiary hospital from Jan 2019 to Jun2019 and underwent DTR after PG were analyzed respectively. The data of this prospective cohort included: clinicopathologic characteristics, surgical outcomes, time to first flatus and defecation, Visick Score, degrees and extent of remnant gastritis, Los Angles Classification in 1-year follow-up.Results The mean operation time was 206.54±75.44 min; estimated blood loss was 128.85±48.38 ml; length of proximal and distal resection margin were 2.53±0.83 and 4.86±1.49 cm; and number of retrieved lymph nodes reached 23.54±8.04. The postoperative complication rate was 8% (n = 2), which were both treated by conservative management. The postoperative gut function improved gradually and the volume of postoperative daily intake could reach over 700ml on 6th POD. The levels of albumin and prealbumin returned to normal status and weight loss also remained steadily at 3-month after operation. The rate of reflux symptoms was 12% (n = 3), which were classified as Visick grade II at 1-year follow-up after operation. ConclusionThe short-term outcome of this modified DTR was satisfied, which could improve the nutrition status and quality of life post operation.Trial registrationChiCTR, ChiCTR 1900024826. Registered 29 July 2019. https://www.chictr.org.cn/searchproj.aspx?title=&officialname=&subjectid=&secondaryid=&applier=&studyleader=ðicalcommitteesanction=&sponsor=&studyailment=&studyailmentcode=&studytype=0&studystage=0&studydesign=0&minstudyexecutetime=&maxstudyexecutetime=&recruitmentstatus=0&gender=0&agreetosign=&secsponsor=®no=ChiCTR1900024826®status=0&country=&province=&city=&institution=&institutionlevel=&measure=&intercode=&sourceofspends=&createyear=0&isuploadrf=&whetherpublic=&btngo=btn&verifycode=&page=1
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