Health-related quality of life analysis in differentiated thyroid carcinoma patients after thyroidectomy

Abstract

Although differentiated thyroid carcinoma (DTC) has a good prognosis and survival rate, long-term medication and recurrence monitoring might be needed. The factors that affect postoperative healthrelated quality of life (HRQoL) in patients with DTC in different regions remain unclear or conflicting. The purpose of this study was to assess the factors that influence the HRQoL of DTC patients after surgery. This study selected 174 patients with DTC who underwent thyroidectomy. Additionally, 174 participants who were matched by age, gender, and socioeconomic status were recruited from the population as the control group. Both the DTC and control population groups were invited to answer the HRQoL questionnaire SF-36. Scores on seven domains of the HRQoL including role-physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role-emotional (RE), and mental health (MH), were significantly lower for DTC patients than for the control population. The patients with no comorbidities had much higher scores on the 8 domains of the SF-36 than DTC patients with two or more comorbidities (all P < 0.05). Hypertension, diabetes and depression were the predictive factors of a poor Physical Component Summary (PCS) score and diabetes and depression were predictive factors of the Mental Component Summary (MCS) score at one year of follow-up (all P < 0.05). HRQoL is significantly influenced by many sociodemographic and clinical factors. Hypertension, diabetes and depression had a negative impact on HRQoL in DTC patients. More attention and targeted intervention should be given to DTC patients after surgery to improve quality of life.Thyroid cancer is the most common malignant tumor of the endocrine system and the head and neck. New cases of thyroid cancer account for approximately 1-5% of all cancers each year 1 . In the past 20 years, the incidence of thyroid cancer has increased each year, causing widespread concern. Differentiated thyroid carcinoma (DTC) frequently occurs in young and middle-aged women 2 . This type of thyroid carcinoma has clinical features of low malignancy, good differentiation, and a slow growth rate 3,4 . However, lymph node metastases can occur months to years after diagnosis, and timely diagnosis and appropriate treatment can result in a favourable outcome.The recommended clinical treatments of differentiated thyroid cancer are subtotal thyroidectomy, total thyroidectomy, radioactive iodine therapy (RAI) and long-term thyroid hormone replacement therapy 5,6 . These treatments can reduce the probability of cancer recurrence, and more than 85% of patients with differentiated thyroid cancer have a good prognosis according to the 10-year survival rates. Current guidelines recommend radioactive iodine ablation after initial thyroidectomy for high-risk patients. For low-risk DTC patients, the recommended surgical approach is unilateral thyroidectomy or total thyroidectomy. Total resection in low-risk DTC patients may be considered overtreatment. Although the advantage of total t...

Hemithyroidectomy vs. total thyroidectomy for minimally invasive follicular thyroid carcinoma: Quality of life and oncological outcomes

“…In a retrospective study, Nickel et al 27 reported that the immediate postoperative QoL was better after HT than after TT in patients treated for DTC. Li et al 28 compared HRQoL at 1 year, using the SF‐36 questionnaire, between patients treated with thyroidectomy and a control group. They concluded that the major determinants of HRQoL deterioration after thyroidectomy were diabetes mellitus, hypertension and depression.…”

Long-Term Quality of Life (5-15 Years Post-Thyroidectomy) of Thyroid Carcinoma Patients in Two Tertiary Care Hospitals

“…The QOL of DTC patients was evaluated at one year of follow-up. DTC patients showed much lower scores on different domains except for physical functioning, which was measured using the SF-36 questionnaire [13].…”

“…Voice alteration, swallowing dysfunction, pain, fatigue, appearance of scar, and concern about weight gain are several thyroid-specific quality of life (QOL) issues identified by previous studies [10][11][12][13][14]. Moreover, some patients struggle to cope with and adapt to the lifelong thyroid hormone replacement postthyroidectomy [15].…”

Quality of life and surgical outcome of ABBA versus EndoCATS endoscopic thyroid surgery: a single center experience

“…In a recently published randomized controlled trial, QoL significantly increased after surgery in a cohort with euthyreotic Hashimoto's disease compared to a cohort only receiving hormone substitution alone [45]. Altogether, QoL data in thyroid surgery are sparse to find in literature and in the available data most patients perform worse in different aspects of QoL with thyroid disease and even after thyroid surgery for years in benign or malign disease [43,44,[46][47][48]. Therefore, the decrease especially in physical health composite scale, may not be due to the surgery itself.…”

“…Remote access endoscopic thyroid surgery like EndoCATS and ABBA procedures can be safely performed with an excellent cosmetic outcome and highly satisfied patients. The QoL in these patients is impaired, but presumably independent of surgery or surgical technique [ 43 , 44 , 46 , 47 ].…”