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Kim W, Lee JK, Yu HW, Kim SJ, Chai YJ, Choi JY, Lee KE. Observation of changes in quality of life for 5 years after thyroid surgery: an observational cross-sectional study in Korean population. Ann Surg Treat Res 2023; 105:264-270. [PMID: 38023433 PMCID: PMC10648617 DOI: 10.4174/astr.2023.105.5.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose As thyroid cancer patients are experiencing longer disease-free survival periods, evaluating their quality of life after surgery has become crucial. However, studies on this topic have primarily focused on Western populations, leaving a gap in understanding the Korean patient population's experiences and needs. This study aims to address this gap and provide insights into the quality of life of thyroid cancer patients in Korea. Methods This cross-sectional study evaluated the quality of life of Korean thyroid cancer patients who underwent thyroid lobectomy or total thyroidectomy. Patients were surveyed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30, ver. 3.0) during outpatient clinic visits from January to September 2015. The results were analyzed by comparing them to scores of the general population and based on the time elapsed since surgery. This approach allowed for a comprehensive evaluation of the quality-of-life outcomes in this patient population. Results The study found that thyroidectomy had a notable impact on patients' role and cognitive functions. Patients also experienced worsened symptoms such as fatigue, dyspnea, and constipation, which improved over time and returned to normal levels. However, there were no significant changes in other functions and symptoms after surgery. Conclusion The study's findings showed that thyroidectomy had a relatively minor impact on the functional and symptomatic well-being of patients. Therefore, the results suggest that thyroid surgery may be a safe and effective treatment option for thyroid cancer patients seeking to maintain a good quality of life.
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Affiliation(s)
- Woochul Kim
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Ja Kyung Lee
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyeong Won Yu
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Su-jin Kim
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Young Jun Chai
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
- Department of Surgery, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - June Young Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyu Eun Lee
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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2
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Su YR, Yu XP, Huang LQ, Xie L, Zha JS. Factors influencing postoperative anxiety and depression following Iodine-131 treatment in patients with differentiated thyroid cancer: A cross-sectional study. World J Psychiatry 2023; 13:486-494. [PMID: 37547735 PMCID: PMC10401505 DOI: 10.5498/wjp.v13.i7.486] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 07/17/2023] Open
Abstract
BACKGROUND Differentiated thyroid cancer (DTC) often seriously impacts patients’ lives. Radionuclide Iodine-131 (131I) is widely used in treating patients with DTC. However, most patients know little about radionuclide therapy, and the treatment needs to be performed in a special isolation ward, which can cause anxiety and depression.
AIM To explore anxiety and depression status and their influencing factors after 131I treatment in patients with DTC.
METHODS A questionnaire survey was conducted among postoperative patients with DTC who received 131I treatment at our hospital from June 2020 to December 2022. General patient data were collected using a self-administered demographic characteristics questionnaire. The self-rating depression scale and self-rating anxiety scale were used to determine whether patients were worried about their symptoms and the degree of anxiety and depression. The patients were cate-gorized into anxiety, non-anxiety, depression, and non-depression groups. Single-variable and multiple-variable analyses were used to determine the risk factors for anxiety and depression in patients with thyroid cancer after surgery.
RESULTS A total of 144 patients were included in this study. The baseline mean score of self-rating anxiety and depression scales were 50.06 ± 16.10 and 50.96 ± 16.55, respectively. Notably, 48.62% (70/144) had anxiety and 47.22% (68/144) of the patients had depression. Sex, age, education level, marital status, household income, underlying diseases, and medication compliance significantly differed among groups (P < 0.05). Furthermore, multivariate logistic regression analysis showed that education level, per capita monthly household income, and medication compliance level affected anxiety (P = 0.015, 0.001, and 0.001 respectively. Patient’s sex, marital status, and underlying diseases affected depression (P = 0.007, 0.001, and 0.009, respectively).
CONCLUSION Nursing interventions aiming at reducing the risk of anxiety and depression should target unmarried female patients with low education level, low family income, underlying diseases, and poor adherence to medications.
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Affiliation(s)
- Ying-Rui Su
- Department of Nuclear Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Xiao-Peng Yu
- Department of Nuclear Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Li-Qun Huang
- Department of Nuclear Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Long Xie
- Department of Nuclear Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Jin-Shun Zha
- Department of Nuclear Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
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3
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Alexander K, Lee SYC, Georgiades S, Constantinou C. The "not so good" thyroid cancer: a scoping review on risk factors associated with anxiety, depression and quality of life. J Med Life 2023; 16:348-371. [PMID: 37168306 PMCID: PMC10165516 DOI: 10.25122/jml-2022-0204] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 01/10/2023] [Indexed: 05/13/2023] Open
Abstract
The incidence of thyroid cancer has increased in recent years, leading to a growing number of survivors facing lifelong consequences. This scoping review investigated anxiety, depression, and quality of life (QoL) in thyroid cancer survivors compared to the general population, those with benign pathology, and survivors of other types of cancers. Moreover, we aimed to identify the risk factors associated with anxiety, depression, and QoL in thyroid cancer patients. A total of 727 articles were identified through PubMed, ProQuest, Cochrane, and Google Scholar databases, and 68 articles that met the criteria were selected for data extraction. Thyroid cancer survivors have a poorer QoL compared to the general population, population with benign pathology, and survivors of other types of cancer associated with worse clinical outcomes. The main risk factors are grouped into socioeconomic factors, disease-specific factors, management factors, comorbidities, and patient perceptions. Effective communication between the patient and the medical team and behavioral interventions may reduce these risks. Despite the common perception of thyroid cancer as a "good cancer," the findings of this review demonstrate the need to address the risk factors associated with increased anxiety, depression, and lower QoL in survivors.
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Affiliation(s)
- Kyle Alexander
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus
| | - Sum-Yu Christina Lee
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus
| | - Stelios Georgiades
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus
| | - Constantina Constantinou
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus
- Corresponding Author: Constantina Constantinou, Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus. E-mail:
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Watt T, Christoffersen T, Brogaard MB, Bjorner JB, Bentzen J, Hahn CH, Nygaard B, Feldt-Rasmussen U. Quality of life in thyroid cancer. Best Pract Res Clin Endocrinol Metab 2023; 37:101732. [PMID: 36732089 DOI: 10.1016/j.beem.2023.101732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
To explore the impact of differentiated thyroid cancer (DTC) on quality of life (QoL) a clinical analytical framework was developed. Based on the clinical analytical framework, a systematic literature search was performed to identify studies applying patient-reported outcomes (PRO) instruments among patients with DTC. Subsequently, the scope was narrowed down to studies comparing scores on the Medical Outcomes Study (MOS) Short form 36 (SF-36) to a reference population (clinical interpretability criterion). Further, the currently available thyroid cancer (TC) specific QoL PROs were review in accordance with the standards of the International Society of Quality of Life Research. In the initial search, 213 studies were included. The additional 'clinical interpretability'-criteria, limited the final study sample to 16 studies, 13 cross-sectional and 3 longitudinal. QoL was impacted across all SF-36 scales. The impact was generally modest and the impact was impeded by time since diagnosis and treatment. Four TC specific instruments were identified. Generally, the documentation of their measurement properties, particularly content validity and clinical validity, including substantial quantitative validation, was scarce. As was the cross-cultural applicability of the currently available instruments. This restricted, focused, clinically founded review showed an impact on a broad range of QoL issues. There is a need for large-scale measurement of QoL outcome longitudinally, using well-validated PRO instruments in order to identify with certainty the impact on subgroups.
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Affiliation(s)
- Torquil Watt
- Department of Endocrinology and Metabolism, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Thea Christoffersen
- Department of Clinical Pharmacology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Mathilde Borring Brogaard
- Department of Endocrinology and Metabolism, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
| | - Jakob Bue Bjorner
- QualityMetric Incorporated, LLC, Johnston, RI, USA; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jens Bentzen
- Department of Oncology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
| | - Christoffer Holst Hahn
- Department of Otorhinolaryngology and Neck Surgery, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Birte Nygaard
- Department of Endocrinology and Metabolism, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
| | - Ulla Feldt-Rasmussen
- Department of Endocrinology and Metabolism, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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5
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Ming H, Yu H, Liu Y, Yang L, Chen Y. Effect of radioiodine therapy under thyroid hormone withdrawal on health-related quality of life in patients with differentiated thyroid cancer. Jpn J Clin Oncol 2022; 52:1159-1166. [PMID: 35848939 DOI: 10.1093/jjco/hyac113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To investigate the effect of radioactive iodine therapy under thyroid hormone withdrawal in differentiated thyroid cancer patients on health-related quality of life. METHODS Patients who were diagnosed with differentiated thyroid cancer after thyroidectomy were involved in this study. All of them were managed with thyroid hormone withdrawal. Health-related quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and its thyroid cancer module at three different time points. Changes in health-related quality of life were evaluated by Wilcoxon and Kruskal-Wallis tests. Univariable logistic regression analysis was used to determine social-demographic and clinical factors associated with worse health-related quality of life. RESULTS A total of 99 differentiated thyroid cancer patients were involved in this study. Changes in health-related quality of life at different time points showed that 1 month post-radioactive iodine treatment, an improvement in nausea and vomiting, insomnia and appetite loss was observed. Impairments of global health, role, cognitive and social function and problems of discomfort in the head and neck, voice concerns, dry mouth, fatigue, pain, dyspnea, thyroid fatigue, fear, tingling or numbness, joint pain and shoulder function increased after radioactive iodine treatment. Univariable logistic regression analysis demonstrated potential factors associated with worse health-related quality of life. Thyroid stimulating hormone and parathyroid hormone levels were more sensible to changes in functional domain. Patients aged ≥55-year-old, with annual income under ¥50 000, low parathyroid hormone and pT4 tumour stage experienced higher changes in symptom scales after radioactive iodine treatment. CONCLUSION After radioactive iodine treatment, differentiated thyroid cancer patients experienced negative health-related quality of life, and most of these impairments might not recover in the short term. Thyroid stimulating hormone and parathyroid hormone levels, annual income and pT tumours stage were independent risk factors for decreased health-related quality of life.
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Affiliation(s)
- Hui Ming
- Department of Nuclear Medicine, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Huangshi, China
| | - Hui Yu
- Department of Nuclear Medicine, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Huangshi, China
| | - Yangbao Liu
- Department of Nuclear Medicine, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Huangshi, China
| | - Lihua Yang
- Department of Nuclear Medicine, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Huangshi, China
| | - Yuanhao Chen
- Department of Nuclear Medicine, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Huangshi, China
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Mahl C, Santos ADD, Lima SVMA. Tendência Temporal e Distribuição Espacial da Mortalidade por Câncer de Boca em Sergipe. REVISTA BRASILEIRA DE CANCEROLOGIA 2022. [DOI: 10.32635/2176-9745.rbc.2022v68n2.2087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introdução: Anualmente, no Brasil, 15 mil pessoas são diagnosticadas com câncer de boca, e quase metade delas morre. Sergipe está entre os sete Estados brasileiros com maiores índices. Objetivo: Analisar a tendência temporal e a distribuição espacial da mortalidade por câncer de boca em Sergipe entre 2007 e 2016. Método: Estudo ecológico de série temporal de base populacional, utilizando técnicas de análise espacial. Os dados de mortalidade foram obtidos no Sistema de Informação sobre Mortalidade (SIM). A análise das tendências temporais foi realizada no modelo de regressão de Joinpoint por meio da regressão de Poisson. Foram realizadas análises espaciais utilizando o estimador de intensidade Kernel e os índices de Moran Global e Local. Resultados: Foram analisadas 543 mortes por câncer de boca. Os casos mais frequentes ocorreram em homens (74%), com idade média de 64 anos e baixa escolaridade. As taxas de mortalidade global (variação percentual anual ‒ APC=2,5; IC 95% 0,9-6,7) e masculina (APC=2,96; IC 95% 1,2-5,6) aumentaram. Houve também uma tendência crescente de mortalidade por câncer na língua (APC=10,05; IC 95% 3,8-16,7). A mortalidade relacionada a outras localizações anatômicas foi estável. Houve concentração de óbitos nas Regiões Metropolitana, Centro-Sul e Centro-Agreste. Conclusão: Durante o período analisado, a taxa de mortalidade geral mostrou uma tendência crescente, com concentração nas Regiões Centro-Sul, Central e Metropolitana, sendo necessário manter medidas de prevenção e controle contra o câncer de boca em todo o Estado de Sergipe.
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7
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Yang X, Yang Q, Tang Y, Ma J, Ye H. Impact of the Extent of Thyroidectomy on Quality of Life in Differentiated Thyroid Cancer Survivors: A Propensity Score Matched Analysis. Cancer Manag Res 2021; 13:6953-6967. [PMID: 34522138 PMCID: PMC8434861 DOI: 10.2147/cmar.s321988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/16/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose As most thyroid cancer patients survive for more than ten years, it has become increasingly important to understand whether the different surgery types have any effect on the quality of life (QoL) of patients. Patients and Methods Using observational data from head and neck surgery at the Sichuan Cancer Hospital in China, three scoring methods – sum scoring, domain-based scoring and IRT-based scoring, were employed to measure the QoL in differentiated thyroid cancer (DTC) patients and a propensity score matched analysis performed to explore the impact of surgery type on QoL as measured by the Treatment of Cancer Quality of Life core Questionnaire version 3.0 (EORTC QLQ-C30) and a disease-specific health-related quality of life questionnaire (THYCA-QoL). Results No statistically significant patient QoL differences were found between the two surgery types regardless of which questionnaire was used and which scoring method was used (\documentclass[12pt]{minimal}
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$$p = 0.834$$
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$${\rm{ATE}} = - 0.4491$$
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$$p = 0.807$$
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$${\rm{ATE}} = - 0.442$$
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$$p = 0.114$$
\end{document} using the EORTC QLQ-C30 and the IRT-based scoring; \documentclass[12pt]{minimal}
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$${\rm{ATE}} = - 0.827$$
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$$p = 0.586$$
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$${\rm{ATE}} = - 1.692$$
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$$p = 0.406$$
\end{document} using the THYCA-QoL and the domain-based scoring; and \documentclass[12pt]{minimal}
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$${\rm{ATE}} = - 0.032$$
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$$p = 0.908$$
\end{document} using the THYCA-QoL and the IRT-based scoring). Conclusion This study confirmed that the surgery type (hemithyroidectomy or total thyroidectomy) for DTC patients did not appear to influence their general QoL.
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Affiliation(s)
- Xiongtao Yang
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, People's Republic of China
| | - Qing Yang
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, People's Republic of China
| | - Yuan Tang
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, People's Republic of China
| | - Jing Ma
- Business School, Sichuan University, Chengdu, 610064, People's Republic of China
| | - Huamei Ye
- People's Hospital of Dujiangyan City, Chengdu, 611830, People's Republic of China
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Walshaw EG, Smith M, Kim D, Wadsley J, Kanatas A, Rogers SN. Systematic review of health-related quality of life following thyroid cancer. TUMORI JOURNAL 2021; 108:291-314. [PMID: 34387109 PMCID: PMC9310144 DOI: 10.1177/03008916211025098] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This systematic review provides a summary of all studies published between 2000 and 2019 using a health-related quality of life (HRQOL) patient-completed questionnaire to report outcomes following diagnosis and treatment of thyroid cancer. The search terms were “thyroid cancer” or “thyroid carcinoma,” “quality of life” or “health related quality of life,” and “questionnaire” or “patient reported outcome.” EMBASE, PubMed, Medline, PsycINFO, CINAHL, and HaNDLE-On-QOL search engines were searched between 2 February and 23 February 2020. A total of 811 identified articles were reduced to 314 when duplicates were removed. After exclusion criteria (not thyroid specific, no quality of life questionnaires, and conference abstracts) were applied, 92 remained. Hand searching identified a further 2 articles. Of the 94 included, 16 had a surgical, 26 a primarily medical, and 52 a general focus. There were articles from 27 countries. A total of 49 articles were published from 2015 through 2019 inclusive. A total of 72 questionnaires were used among the articles and a range of 7 to 2215 participants were included within each article. This review demonstrated an increasing number of publications annually. The scope of enquiry into aspects of HRQOL following thyroid cancer is broad, with relatively few addressing surgical aspects and many focusing on the impact of radio-iodine. More research is required into shared decision-making in initial management decisions and HRQOL and interventions aimed specifically at addressing long-term HRQOL difficulties.
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Affiliation(s)
| | - Mike Smith
- Dental student, Liverpool University, Liverpool, UK
| | - Dae Kim
- Consultant ENT and head & neck surgeon, St George's University Hospital, London, UK
| | - Jonathan Wadsley
- Consultant clinical oncologist, Weston Park Cancer Centre, Sheffield, UK
| | - Anastasios Kanatas
- Oral and maxillofacial surgery consultant, Leeds Teaching Hospitals and St James Institute of Oncology, Leeds Dental Institute and Leeds General Infirmary, Leeds, UK
| | - Simon N Rogers
- Faculty of Health and Social Care, Edge Hill University, Liverpool, UK.,Consultant, Liverpool Head and Neck Centre, Liverpool University Hospital, Liverpool, UK
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Chan WL, Choi HCW, Lang B, Wong KP, Yuen KK, Lam KO, Lee VHF, Kwong D. Health-Related Quality of Life in Asian Differentiated Thyroid Cancer Survivors. Cancer Control 2021; 28:10732748211029726. [PMID: 34189945 PMCID: PMC8252343 DOI: 10.1177/10732748211029726] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Health-related quality of life (HRQoL) is important for differentiated thyroid cancer survivors, but data for Asian survivors is lacking. This study aimed to have an overview of, and identify any disease-or treatment-related factors associated with, HRQoL in Asian differentiated thyroid cancer survivors. Patients and Methods: Thyroid cancer survivors were recruited from the thyroid clinics at Queen Mary Hospital, Hong Kong from February 2016 to December 2016. All adult differentiated thyroid cancer patients with stable disease more than or equal to 1 year received a survey on HRQoL using the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and Thyroid cancer specific quality of life (THYCA-QoL) questionnaire. Clinical information was collected retrospectively from the computerized clinical management system. To identify factors associated with poor HRQoL, univariable and stepwise multivariable regression analysis were performed. Results: A total of 613 survivors completed the questionnaires (response rate: 82.1%; female: 80.1%; median survivorship: 7.4 years (range: 1.0-48.2 years)). The QLQ-C30 summary score mean was 84.4 (standard deviation (SD): 12.7) while the THYCA-QoL summary score mean was 39.9 (SD: 9.7). The 2 highest symptom subscales were fatigue (mean: 26.4, SD: 20.6) and insomnia (mean: 26.2, SD: 27.6). Factors associated with worse HRQoL included serum thyrotropin (TSH) greater than 1.0 mIU/L, unemployment, and concomitant psychiatric disorders. Concomitant psychiatric illness (n = 40/613, 6.5%) also showed significant association with most of the symptom and functional subscales. Conclusions: Fatigue and insomnia were the 2 most common symptoms experienced by our differentiated thyroid cancer survivors. Long-term survivorship care with monitoring serum TSH level, supporting return-to-work and screening for concomitant psychiatric disorders should be offered.
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Affiliation(s)
- Wing-Lok Chan
- Department of Clinical Oncology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Horace Cheuk-Wai Choi
- Department of Clinical Oncology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Brian Lang
- Department of Surgery, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Kai-Pun Wong
- Department of Surgery, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Kwok-Keung Yuen
- Department of Clinical Oncology, Queen Mary Hospital, Hong Kong
| | - Ka-On Lam
- Department of Clinical Oncology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Victor Ho-Fun Lee
- Department of Clinical Oncology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Dora Kwong
- Department of Clinical Oncology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
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Houten R, Fleeman N, Kotas E, Boland A, Lambe T, Duarte R. A systematic review of health state utility values for thyroid cancer. Qual Life Res 2020; 30:675-702. [PMID: 33098494 PMCID: PMC7952343 DOI: 10.1007/s11136-020-02676-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2020] [Indexed: 11/28/2022]
Abstract
Purpose Health state utility values are commonly used to inform economic evaluations and determine the cost-effectiveness of an intervention. The aim of this systematic review is to summarise the utility values available to represent the health-related quality of life (HRQoL) of patients with thyroid cancer. Methods Eight electronic databases were searched from January 1999 to April 2019 for studies which included assessment of HRQoL for patients with thyroid cancer. Utility estimates derived from multiple sources (EuroQol questionnaire 5-dimension (EQ-5D), time trade-off [TTO] and standard gamble [SG] methods) were extracted. In addition, utility estimates were generated by mapping from SF-36 and EORTC QLQ-30 to the EQ-5D-3L UK value set using published mapping algorithms. Results Searches identified 33 eligible studies. Twenty-six studies reported HRQoL for patients with differentiated thyroid cancer and seven studies for patients with general thyroid cancer. We identified studies which used different methods and tools to quantify the HRQoL in patients with thyroid cancer, such as the EQ-5D-3L, SF-36, EORTC QLQ-30 and SG and TTO techniques to estimate utility values. Utility estimates range from 0.205 (patients with low-risk differentiated thyroid cancer) to utility values approximate to the average UK population (following successful thyroidectomy surgery and radioiodine treatment). Utility estimates for different health states, across thyroid cancer sub-types and interventions are presented. Conclusion A catalogue of utility values is provided for use when carrying out economic modelling of thyroid cancer; by including mapped values, this approach broadens the scope of health states that can be considered within cost-effectiveness modelling. Electronic supplementary material The online version of this article (10.1007/s11136-020-02676-2) contains supplementary material, which is available to authorised users.
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Affiliation(s)
- Rachel Houten
- Liverpool Reviews and Implementation Group, University of Liverpool, 2.06 Whelan Building, The Quadrangle, Brownlow Hill, Liverpool, L69 3GB, UK.
| | - Nigel Fleeman
- Liverpool Reviews and Implementation Group, University of Liverpool, 2.06 Whelan Building, The Quadrangle, Brownlow Hill, Liverpool, L69 3GB, UK
| | - Eleanor Kotas
- Liverpool Reviews and Implementation Group, University of Liverpool, 2.06 Whelan Building, The Quadrangle, Brownlow Hill, Liverpool, L69 3GB, UK.,York Health Economics Consortium, University of York, York, UK
| | - Angela Boland
- Liverpool Reviews and Implementation Group, University of Liverpool, 2.06 Whelan Building, The Quadrangle, Brownlow Hill, Liverpool, L69 3GB, UK
| | - Tosin Lambe
- Liverpool Reviews and Implementation Group, University of Liverpool, 2.06 Whelan Building, The Quadrangle, Brownlow Hill, Liverpool, L69 3GB, UK
| | - Rui Duarte
- Liverpool Reviews and Implementation Group, University of Liverpool, 2.06 Whelan Building, The Quadrangle, Brownlow Hill, Liverpool, L69 3GB, UK
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Banihashem S, Arabzadeh M, Jafarian Bahri RS, Qutbi M. Psychological Status and Quality of Life Associated with Radioactive Iodine Treatment of Patients with Differentiated Thyroid Cancer: Results of Hospital Anxiety and Depression Scale and Short-Form (36) Health Survey. Indian J Nucl Med 2020; 35:216-221. [PMID: 33082677 PMCID: PMC7537913 DOI: 10.4103/ijnm.ijnm_14_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 02/18/2020] [Accepted: 03/04/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose: The objective is to investigate psychological status and quality of life (QoL) using Hospital Anxiety and Depression Scale (HADS) and Short-Form (36) Health Survey (SF-36) questionnaires in patients with proven differentiated thyroid cancer (DTC) who are referred for radioactive iodine (RAI) ablation before, during, and after treatment. Methods: Of patients who underwent total thyroidectomy with a pathologically proven DTC (papillary and follicular types) referred for RAI treatment to our department in 2018, 150, in whom the diagnosis was newly established, were referred for the first course of RAI treatment and were consecutively enrolled in the study. The patients received an oral dose of radioiodine (3700 or 5550 MBq). For evaluation of anxiety, depression, and QoL, all patients are given two standard questionnaires, HADS, and SF-36 and are requested to answer them at four time points. First one was at 1 month before RAI, second was at the time of RAI treatment. Third and fourth ones were 1 week and 6 months later, respectively. Results: The mean age of patients was 39.17 (±12.95) years and 121 (80.7%) were female and 29 (19.3%) were male. Values of HADS and SF-36 scores at corresponding time points were significantly correlated using Pearson correlation (HADS and SF-36 scores at 1 month before RAI: r = −0.56, P < 0.001; at time of RAI: r = −0.71, P < 0.001; 6 months after RAI: r = 0.19, P = 0.021). Using paired-sample t-test, for HADS, except for difference between time points of 1 month before RAI and time of RAI, pairwise difference between scores of other time points was statistically significant after Bonferroni correction. For SF-36, pairwise difference between scores of all three time points was statistically significant. Interaction of age, gender, RAI dose, and thyroid-stimulating hormone level at the time of RAI on HADS and SF-36 scores did not show statistical significance. Conclusion: Trend in scores over several-months’ time discloses gradual improvement of QoL and merits close observation but limited psychiatric intervention.
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Affiliation(s)
- Seyedshahab Banihashem
- Department of Psychosomatic Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Arabzadeh
- Department of Psychosomatic Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reyhaneh Sadat Jafarian Bahri
- Department of Psychosomatic Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Qutbi
- Department of Nuclear Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Li J, Xue LB, Gong XY, Yang YF, Zhang BY, Jin J, Shi QF, Liu YH. Risk Factors of Deterioration in Quality of Life Scores in Thyroid Cancer Patients After Thyroidectomy. Cancer Manag Res 2019; 11:10593-10598. [PMID: 31908531 PMCID: PMC6927570 DOI: 10.2147/cmar.s235323] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 12/04/2019] [Indexed: 12/25/2022] Open
Abstract
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.
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Affiliation(s)
- Jie Li
- Thyroid and Breast Surgery, Cangzhou Central Hospital, Cangzhou City061000, People’s Republic of China
| | - Ling Bo Xue
- Thyroid and Breast Surgery, Cangzhou Central Hospital, Cangzhou City061000, People’s Republic of China
| | - Xiao Yi Gong
- Thyroid and Breast Surgery, Cangzhou Central Hospital, Cangzhou City061000, People’s Republic of China
| | - Yan Fang Yang
- Thyroid and Breast Surgery, Cangzhou Central Hospital, Cangzhou City061000, People’s Republic of China
| | - Bu Yong Zhang
- Thyroid and Breast Surgery, Cangzhou Central Hospital, Cangzhou City061000, People’s Republic of China
| | - Jian Jin
- Thyroid and Breast Surgery, Cangzhou Central Hospital, Cangzhou City061000, People’s Republic of China
| | - Qing Feng Shi
- Thyroid and Breast Surgery, Cangzhou Central Hospital, Cangzhou City061000, People’s Republic of China
| | - Yong Hong Liu
- Thyroid and Breast Surgery, Cangzhou Central Hospital, Cangzhou City061000, People’s Republic of China
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