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Liu L, Xiang Y, Xiong L, Li C, Dai W, Hu J, Shui C, Zhou Y, Wang X, Ma L, Xu N, Hu B, Cai Y. Assessment of preoperative health-related quality of life in patients undergoing thyroidectomy based on patient-reported outcomes. Front Psychol 2024; 15:1329175. [PMID: 39176053 PMCID: PMC11339645 DOI: 10.3389/fpsyg.2024.1329175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 07/17/2024] [Indexed: 08/24/2024] Open
Abstract
Introduction To evaluate the preoperative health-related quality of life (HRQoL) and influencing factors of HRQoL in patients undergoing thyroidectomy based on patient-reported outcomes. Materials and methods Patients who were diagnosed and treated in Sichuan Cancer Hospital from February 2022 to December 2022 and were scheduled to undergo thyroidectomy were included. Each participant completed the basic information questionnaire and patient-reported outcome assessment scales before surgery. HRQoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30), the Thyroid Cancer-Specific Quality of Life (THYCA-QoL), and the Hamilton Anxiety Scale (HAMA). The Wilcoxon rank sum test or the Kruskal-Wallis test was used to analyze the association between patient characteristics and HRQoL, and the variables with statistical significance were included in multiple linear regression analysis. Results 450 patients were included in the study. According to the analysis of the THYCA-QoL scores, the psychological subscale was the most complained about. Anxiety was the most common symptom of the HAMA. Factors associated with worse general QoL on the EORTC QLQ-C30 included nondiagnostic/unsatisfactory fine-needle aspiration (FNA) result. Planned lateral neck dissection and nondiagnostic/unsatisfactory FNA result were influential factors for preoperative anxiety. Males and longer sleep duration were associated with better thyroid cancer-specific QoL, better general QoL, and less anxiety. Conclusion The preoperative HRQoL of patients undergoing thyroidectomy was generally good. Females, insufficient sleep duration, planned lateral neck dissection, and nondiagnostic/unsatisfactory FNA result were associated with worse preoperative HRQoL.
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Affiliation(s)
- Lei Liu
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuqing Xiang
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
- Graduate School, Chengdu Medical College, Chengdu, China
| | - Lujing Xiong
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Chao Li
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Wei Dai
- Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Jinchuan Hu
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
- Graduate School, Chengdu Medical College, Chengdu, China
| | - Chunyan Shui
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Yuqiu Zhou
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Xu Wang
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Linjie Ma
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Nan Xu
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Bintao Hu
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
- Graduate School, Chengdu Medical College, Chengdu, China
| | - Yongcong Cai
- Department of Head and Neck Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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Chen S, Hu X, Yang P, Yang L, Peng S, He L, Yuan L, Bao G. Status of mental and social activities of young and middle-aged patients after papillary thyroid cancer surgery. Front Oncol 2024; 14:1338216. [PMID: 38595812 PMCID: PMC11002165 DOI: 10.3389/fonc.2024.1338216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/12/2024] [Indexed: 04/11/2024] Open
Abstract
Background Papillary thyroid cancer (PTC) is prevalent among younger populations and has a favorable survival rate. However, a significant number of patients experience psychosocial stress and a reduced quality of life (QoL) after surgical treatment. Therefore, comprehensive evaluations of the patients are essential to improve their recovery. Methods The present study enrolled 512 young and middle-aged patients diagnosed with PTC who underwent surgery at our institution between September 2020 and August 2021. Each participant completed a series of questionnaires: Generalized Anxiety Disorder 7 (GAD-7), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), Thyroid Cancer-Specific Quality of Life Questionnaire (THYCA-QoL), and Readiness to Return-to-Work Scale (RRTW). Results GAD-7 data showed that almost half of the study subjects were experiencing anxiety. Regarding health-related quality of life (HRQoL), participants reported the highest levels of fatigue, insomnia, voice problems, and scarring, with patients in anxious states reporting worse symptoms. Based on RRTW, more than half of the subjects had returned to work and had better HRQoL compared to the others who were evaluating a possible return to work. Age, gender, BMI, education, diet, residence, health insurance, months since surgery, monthly income, and caregiver status were significantly correlated with return to work. Additionally, having a caregiver, higher monthly income, more time since surgery, and living in a city or village were positively associated with return to work. Conclusion Young and middle-aged patients with PTC commonly experience a range of health-related issues and disease-specific symptoms following surgery, accompanied by inferior psychological well-being, HRQoL, and work readiness. It is crucial to prioritize timely interventions targeting postoperative psychological support, HRQoL improvement, and the restoration of working ability in PTC patients.
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Affiliation(s)
- Songhao Chen
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an, China
- Department of Obstetrics and Gynecology, The 920 Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army (PLA), Kunming, China
| | - Xi’e Hu
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an, China
| | - Ping Yang
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an, China
| | - Lin Yang
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an, China
| | - Shujia Peng
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an, China
| | - Li He
- Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Lijuan Yuan
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an, China
| | - Guoqiang Bao
- Department of General Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an, China
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Park YI, Cho MS, Chang JS, Kim JS, Kim YB, Lee IJ, Hong CS, Choi SH. Normal tissue complication probability models of hypothyroidism after radiotherapy for breast cancer. Clin Transl Radiat Oncol 2024; 45:100734. [PMID: 38317677 PMCID: PMC10839258 DOI: 10.1016/j.ctro.2024.100734] [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: 12/13/2023] [Revised: 01/19/2024] [Accepted: 01/21/2024] [Indexed: 02/07/2024] Open
Abstract
Purpose We aimed to develop Lyman-Kutcher-Burman (LKB) and multivariable normal tissue complication probability (NTCP) models to predict the risk of radiation-induced hypothyroidism (RIHT) in breast cancer patients. Materials and methods A total of 1,063 breast cancer patients who underwent whole breast irradiation between 2009 and 2016 were analyzed. Individual dose-volume histograms were used to generate LKB and multivariable logistic regression models. LKB model was fit using the thyroid radiation dose-volume parameters. A multivariable model was constructed to identify potential dosimetric and clinical parameters associated with RIHT. Internal validation was conducted using bootstrapping techniques, and model performance was evaluated using the area under the curve (AUC) and Hosmer-Lemeshow (HL) goodness-of-fit test. Results RIHT developed in 4 % of patients with a median follow-up of 77.7 months. LKB and multivariable NTCP models exhibited significant agreement between the predicted and observed results (HL P values > 0.05). The multivariable NTCP model outperformed the LKB model in predicting RIHT (AUC 0.62 vs. 0.54). In the multivariable model, systemic therapy, age, and percentage of thyroid volume receiving ≥ 10 Gy (V10) were significant prognostic factors for RIHT. The cumulative incidence of RIHT was significantly higher in patients who exceeded the cut-off values for all three risk predictors (systemic therapy, age ≥ 40 years, and thyroid V10 ≥ 26 %, P < 0.005). Conclusions Systemic therapy, age, and V10 of the thyroid were identified as strong risk factors for the development of RIHT. Our NTCP models provide valuable insights to clinicians for predicting and preventing hypothyroidism by identifying high-risk patients.
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Affiliation(s)
- Ye-In Park
- Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Min-Seok Cho
- Department of Radiation Oncology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi do, South Korea
| | - Jee Suk Chang
- Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea
- BC Cancer - Vancouver Centre, Vancouver, British Columbia, Canada
| | - Jin Sung Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Bae Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ik Jae Lee
- Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Chae-Seon Hong
- Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Seo Hee Choi
- Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Korea
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Gómez O, Sanabria A. Quality of life of patients with thyroid cancer in Colombia. ENDOCRINOL DIAB NUTR 2024; 71:61-70. [PMID: 38553170 DOI: 10.1016/j.endien.2024.03.007] [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] [Received: 10/31/2023] [Accepted: 12/29/2023] [Indexed: 04/02/2024]
Abstract
INTRODUCTION Quality of life (QoL) in thyroid cancer patients is comparable to patients with other tumours with worse prognosis. The aim was to evaluate QoL in Colombian patients with thyroid carcinoma and to explore the association of QoL scores with patient features. METHODS This is a cross-sectional study. The present research was carried out from data obtained for the validation study of the Spanish version of the THYCA-QoL. Adult patients with thyroid carcinoma who underwent total or partial thyroidectomy were included and asked to complete the Spanish-validated versions of the THYCA-QoL and EORTC QLQ-C30 questionnaires. The scores of each domain and single items underwent linear transformation to values of 0-100. Comparisons of scale scores with clinical variables were performed. RESULTS We included 293 patients. The global EORTC QLQ-C30 score was 73.2±22.1 and the domains with poorer values were emotional and cognitive and the symptoms with poorer values were insomnia and fatigue. The global THYCA-QOL score was 28.4±17.8. The domains with poorer values were neuromuscular and psychological and the single items with poorer values were headaches and tingling hands/feet. CONCLUSION Colombian patients with thyroid cancer have a good prognosis, but they experience important problems related to QoL. QoL was influenced by demographic and clinical factors such as age, sex functional status and clinical stage.
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Affiliation(s)
- Oscar Gómez
- Department of Surgery, School of Medicine, Universidad de Antioquia, Medellín, Colombia
| | - Alvaro Sanabria
- Department of Surgery, School of Medicine, Universidad de Antioquia, Medellín, Colombia; Head and Neck Service, Fundación Colombiana de Cancerología-Clínica Vida, Medellín, Colombia; Centro de Excelencia en Enfermedades de Cabeza y Cuello, CEXCA, Medellín, Colombia.
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Bach K, Ansari P, Ansari H, Mott NM, Elfenbein DM, Underwood H, Pitt SC. Health-Related Quality of Life in Patients with Low-Risk Differentiated Thyroid Cancer: A Systematic Review Examining the Extent of Thyroidectomy. Thyroid 2024; 34:14-25. [PMID: 37861284 PMCID: PMC10818048 DOI: 10.1089/thy.2023.0328] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
Background: Total thyroidectomy (TT) and hemithyroidectomy (HT) are acceptable surgical options for the treatment of low-risk differentiated thyroid cancer (DTC). While previous data suggest similar disease-free and disease-specific survival regardless of initial surgical treatment, the effect of the extent of surgery on health-related quality of life (HRQOL) is less clear. This systematic review aimed to examine HRQOL in low-risk DTC survivors after TT compared with HT. Methods: A search of PubMed, CINAHL, Cochrane, PsycINFO, and Scopus databases was conducted to identify studies published between January 1, 2011, and December 31, 2022, that assessed HRQOL predominantly in patients with low-risk DTC who underwent open thyroid surgery. Covidence™ software was used to apply the inclusion criteria, and a validated instrument was used to assess study quality. Results: Sixteen of the 1402 identified studies were included: 5 prospective and 11 retrospective cohort studies. The majority of included studies were of good quality (n = 14) and were from Asia and the Middle East (n = 11). Overall, six studies concluded that HT led to a better HRQOL than TT, two concluded that HT only resulted in better HRQOL compared with TT with central neck dissection (CND), and two concluded HT resulted in better short-term HRQOL that dissipated by 6 months postoperatively. The HRQOL domains found across all studies to be most consistently improved after HT included physical health, psychological/emotional, and social function. Factors found to be associated with HRQOL in more than one study included age, stage, and marital status. Conclusion: Differences in HRQOL after HT and TT tended to favor HT particularly when measured <6 months after surgery or when compared with TT with CND. Additional prospective and ideally randomized data are needed to fully determine the impact of the extent of surgery on HRQOL in patients with low-risk thyroid cancer.
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Affiliation(s)
- Kathy Bach
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Palvishey Ansari
- CMH-Lahore Medical College and Institute of Dentistry, Lahore, Pakistan
| | | | - Nicole M. Mott
- Department of Surgery, University of Colorado, Denver, Colorado, USA
| | - Dawn M. Elfenbein
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Hunter Underwood
- Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Susan C. Pitt
- Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
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Agglopoulou O, Gkrinia E, Bizaki-Vallaskangas A, Hajiioannou J, Bizakis I. Quality of Life in Patients With Well-Differentiated Thyroid Carcinoma After Total Thyroidectomy in Greece. Cureus 2024; 16:e53304. [PMID: 38435919 PMCID: PMC10906695 DOI: 10.7759/cureus.53304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2024] [Indexed: 03/05/2024] Open
Abstract
INTRODUCTION Well-differentiated thyroid cancer is among the most common types of endocrine cancer. Despite its increasing prevalence, the prognosis of thyroid cancer is rather good, with a five-year survival rate ranging between 80% and 90%, depending on the histological type. Not only the post-treatment complications and the side effects of the lifelong medication but also the possibility of a recurrence may have a negative impact on the patient's quality of life (QoL). OBJECTIVE The aim of this study is to investigate the impact of total thyroidectomy on the QoL of patients with well-differentiated thyroid carcinoma. METHODS A prospective study was performed in patients who underwent total thyroidectomy due to well-differentiated thyroid carcinoma in the Otolaryngology-Head and Neck Surgery Department at the University Hospital of Larissa, Greece. The QoL was evaluated based on the "Quality of Life (Thyroid Version)" questionnaire. RESULTS One hundred patients participated in the study, with a mean age of 51.24±15.33 years. Of these, 63 (63%) were females and 37 (37%) were males. Social concerns, physical well-being, and psychological well-being presented a gradual positive alteration during the first 12 months after the surgery, with psychological well-being reporting the most significant progress of 15.3%. However, spiritual well-being appeared to decline over time. The younger patients progressively improved their physical, psychological, and mental well-being; however, the older patients showed an amelioration of their social skills. Female patients reported higher levels of spiritual well-being, whereas males developed better social skills. CONCLUSIONS In the long term, total thyroidectomy can ameliorate patients' physical status, psychological well-being, and social concerns. However, it might have a negative effect on their mental health during the first 12 months postoperatively. In addition, QoL is directly influenced by demographic characteristics such as age and gender.
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Affiliation(s)
- Olga Agglopoulou
- Otolaryngology-Head and Neck Surgery, University Hospital of Larissa, Larissa, GRC
| | - Eleni Gkrinia
- Otolaryngology-Head and Neck Surgery, University Hospital of Larissa, Larissa, GRC
| | - Argyro Bizaki-Vallaskangas
- Otolaryngology, Faculty of Medicine and Health Technology, University Hospital of Tampere, Tampere University, Tampere, FIN
| | - Jiannis Hajiioannou
- Otolaryngology-Head and Neck Surgery, University Hospital of Larissa, Larissa, GRC
| | - Ioannis Bizakis
- Otolaryngology-Head and Neck Surgery, Faculty of Medicine, University of Thessaly, Larissa, GRC
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O'Neill CJ, Carlson MA, Rowe CW, Fradgley EA, Paul C. Hearing the Voices of Australian Thyroid Cancer Survivors: Qualitative Thematic Analysis of Semistructured Interviews Identifies Unmet Support Needs. Thyroid 2023; 33:1455-1464. [PMID: 37335225 PMCID: PMC10734898 DOI: 10.1089/thy.2023.0080] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Background: Most thyroid cancer survivors regain their physical health-related quality of life, but psychological and social deficits persist. The nature of these detriments remains poorly understood and they are insufficiently captured by survey data alone. To address this, qualitative data exploring the breadth and depth of thyroid cancer survivors' experiences and priorities for supportive care are required. Methods: Twenty semistructured interviews were undertaken with a purposive, maximum variation sample of thyroid cancer survivors. Interviews were transcribed verbatim and coded independently by two researchers. A hybrid model of inductive and realistic codebook analysis was undertaken with themes developed. Results: Patient experiences centered around three themes: (1) impact of diagnosis and treatment, (2) thyroid cancer does not happen in isolation, and (3) role of clinicians and formalized support structures. The word "cancer" had negative connotations, but for many, the reality of their experience was more positive. Despite feeling "lucky" at the relative low-risk nature of thyroid cancer, many patients reported fatigue, weight gain, and difficulty returning to usual activities; concerns that were largely dismissed or minimized by clinicians. Few were offered any support beyond their treating doctors; where patients attempted to access formalized supportive care, little was available or appropriate. Life stage and concurrent family and social stressors greatly impacted patients' ability to cope with diagnosis and treatment. Addressing thyroid cancer in isolation felt inappropriate without appreciating the broader context of their lives. Interactions with clinicians were largely positive, particularly where information was communicated as a means of empowering patients to participate in shared decision-making and where clinicians "checked in" emotionally with patients. Information about initial treatments was largely adequate but information on longer term effects and follow-up was lacking. Many patients felt that clinicians focused on physical well-being and scan results, missing opportunities to provide psychological support. Conclusions: Thyroid cancer survivors can struggle to navigate their cancer journey, particularly with regard to psychological and social functioning. There is a need to acknowledge these impacts at the time of clinical encounters, as well as develop information resources and support structures that can be individualized to optimize holistic well-being for those in need.
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Affiliation(s)
- Christine J. O'Neill
- Surgical Services, John Hunter Hospital, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Melissa A. Carlson
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Christopher W. Rowe
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Department of Endocrinology, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Elizabeth A. Fradgley
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
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Zhu F, Zhang P, Liu Y, Bao C, Qian D, Ma C, Li H, Yu T. Mendelian randomization suggests a causal relationship between gut dysbiosis and thyroid cancer. Front Cell Infect Microbiol 2023; 13:1298443. [PMID: 38106470 PMCID: PMC10722196 DOI: 10.3389/fcimb.2023.1298443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/06/2023] [Indexed: 12/19/2023] Open
Abstract
Background Alterations in gut microbiota composition and function have been linked to the development and progression of thyroid cancer (TC). However, the exact nature of the causal relationship between them remains uncertain. Methods A bidirectional two-sample Mendelian randomization (TSMR) analysis was conducted to assess the causal connection between gut microbiota (18,340 individuals) and TC (6,699 cases combined with 1,613,655 controls) using data from a genome-wide association study (GWAS). The primary analysis used the inverse-variance weighted (IVW) method to estimate the causal effect, with supplementary approaches including the weighted median, weighted mode, simple mode, and MR-Egger. Heterogeneity and pleiotropy were assessed using the Cochrane Q test, MR-Egger intercept test, and MR-PRESSO global test. A reverse TSMR analysis was performed to explore reverse causality. Results This study identified seven microbial taxa with significant associations with TC. Specifically, the genus Butyrivibrio (OR: 1.127, 95% CI: 1.008-1.260, p = 0.036), Fusicatenibacter (OR: 1.313, 95% CI: 1.066-1.618, p = 0.011), Oscillospira (OR: 1.240, 95% CI: 1.001-1.536, p = 0.049), Ruminococcus2 (OR: 1.408, 95% CI: 1.158-1.711, p < 0.001), Terrisporobacter (OR: 1.241, 95% CI: 1.018-1.513, p = 0.032) were identified as risk factors for TC, while The genus Olsenella (OR: 0.882, 95% CI: 0.787-0.989, p = 0.031) and Ruminococcaceae UCG004 (OR: 0.719, 95% CI: 0.566-0.914, p = 0.007) were associated with reduced TC risk. The reverse MR analysis found no evidence of reverse causality and suggested that TC may lead to increased levels of the genus Holdemanella (β: 0.053, 95% CI: 0.012~0.094, p = 0.011) and decreased levels of the order Bacillales (β: -0.075, 95% CI: -0.143~-0.006, p = 0.033). No significant bias, heterogeneity, or pleiotropy was detected in this study. Conclusion This study suggests a potential causal relationship between gut microbiota and TC, providing new insights into the role of gut microbiota in TC. Further research is needed to explore the underlying biological mechanisms.
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Affiliation(s)
- Feng Zhu
- Department of Gastroenterology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
- Department of Gastroenterology, The First People’s Hospital of Kunshan, Suzhou, China
| | - Pengpeng Zhang
- Department of Lung Cancer Surgery, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Department of Thoracic Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Ying Liu
- Department of General Surgery, Affiliated Hospital of Nanjing University of TCM, Jiangsu Province Hospital of TCM, Nanjing, China
| | - Chongchan Bao
- Department of Breast and Thyroid Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Dong Qian
- Department of General Surgery, Affiliated Hospital of Nanjing University of TCM, Jiangsu Province Hospital of TCM, Nanjing, China
| | - Chaoqun Ma
- Department of General Surgery, Affiliated Hospital of Nanjing University of TCM, Jiangsu Province Hospital of TCM, Nanjing, China
| | - Hua Li
- Department of General Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Ting Yu
- Department of Gastroenterology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
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Zhou L, Li S, Wu Y, Chen Q, Hu X, Jiang J, Shi Y, Shen D, Xie L. Significant dysregulation of lipid metabolism in patients with papillary thyroid carcinoma after thyroidectomy. Front Endocrinol (Lausanne) 2023; 14:1223527. [PMID: 37900134 PMCID: PMC10602777 DOI: 10.3389/fendo.2023.1223527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/25/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Thyroidectomy and thyrotropin suppressive therapy is the widely used surgical treatment for papillary thyroid carcinoma (PTC) patients. However, systematic metabolic changes of post-operative PTC patients were rarely reported. Methods Here, untargeted metabolomic detection of cohorts from PTC before (t0) and 1-month-after (t1) thyroidectomy, were performed to characterize circulating metabolic signatures after surgical treatment. Results Our results showed PTC patients exhibited lower thyroid stimulating hormone degree, higher total thyroxine, and significant lipid-related metabolic alternations after thyroidectomy, which included 97 upregulations (including 93 lipids) and 5 downregulations (including 2 lipids and 3 nucleotides). Enrichment of metabolic pathways mainly included biosynthesis of fatty acids, purine metabolism, and linoleic acid metabolism. We also demonstrated that differential surgical approaches (hemi- and total thyroidectomy) and post-operative complication phenotypes (insomnia, fatigue), might lead to characteristic metabolic signatures. Discussion This study revealed dynamic changes of metabolite characteristics of PTC patients after surgical treatment, which were associated with clinical thyroid function parameters, surgical approaches, and complication occurrence. It enlightened us to pay more attention on the post-operative metabolic dysregulation of PTC patients and their long-term qualities of life, so as to provide cautious clinical decisions on surgical choices, treatments, and follow-up details.
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Affiliation(s)
- Liang Zhou
- Head and Neck Surgery, The affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Shuo Li
- Key Laboratory of Digital Technology in Medical Diagnostics of Zhejiang Province, Dian Diagnostics Group Co., Ltd., Hangzhou, Zhejiang, China
| | - Yuqi Wu
- Key Laboratory of Digital Technology in Medical Diagnostics of Zhejiang Province, Dian Diagnostics Group Co., Ltd., Hangzhou, Zhejiang, China
- Department of Medical, Hangzhou Calibra Diagnostics Co., Ltd, Hangzhou, Zhejiang, China
| | - Qianming Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Hangzhou, Zhejiang, China
| | - Xiaotong Hu
- Pathology, The affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Junchang Jiang
- Pathology, The affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yaoyao Shi
- Pathology, The affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Dan Shen
- Key Laboratory of Digital Technology in Medical Diagnostics of Zhejiang Province, Dian Diagnostics Group Co., Ltd., Hangzhou, Zhejiang, China
| | - Lei Xie
- Head and Neck Surgery, The affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Thanh Vy T, Le Thi Thanh Nam T, Thao Cuong L, Tat Bang H. Health-Related Quality of Life After Thyroid Cancer Surgery: A Single-Center, Cross-Sectional Study in Southern Vietnam. Cureus 2023; 15:e40496. [PMID: 37461749 PMCID: PMC10349926 DOI: 10.7759/cureus.40496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2023] [Indexed: 07/20/2023] Open
Abstract
Background Thyroid cancer is the most common malignant disease in the endocrine glands. Symptoms of the disease affect the functions of organs in the body. Although thyroid cancer is often considered a "good cancer" because it progresses slowly, the likelihood of successful treatment is quite high; what is special is that the effect on the quality of life (QoL) is on par with more severe types of cancer. Currently, studies on QoL assessment in thyroid cancer patients are quite limited in southern Vietnam. The present study investigated the potential risk factors of deterioration in QoL scores in thyroid cancer patients after thyroidectomy. Methodology A descriptive, cross-sectional study was performed on a total of 162 patients who were diagnosed with thyroid cancer and underwent thyroidectomy at the University Medical Center Ho Chi Minh City, Vietnam, from February to May 2023. Data were collected through face-to-face interviews with patients and from medical records. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 was used to assess the QoL one month after thyroidectomy. Multivariable logistic regression was used to identify factors related to QoL with statistical significance set at p-value <0.05. Results The mean overall QoL in thyroid cancer survivors was 84.4 ± 10.00 (on a scale of 0-100, where 100 was the best). The results of multivariate logistic regression analysis showed that the factors related to QoL after thyroidectomy were surgery type (p < 0.001), having a comorbidity (p = 0.029), economic status (p = 0.026), and hormone disorder (p = 0.009). Conclusions Our study indicated that surgery type, having a comorbidity, economic status, and hormone disorders were independent risk factors for decreased QoL one month after thyroidectomy. It is necessary to thoroughly assess the QoL before and after surgery in thyroid cancer patients. Longer follow-up QoL studies should be performed with larger sample sizes for more accurate results.
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Affiliation(s)
- Tran Thanh Vy
- Thoracic and Vascular Department, University Medical Center Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, VNM
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, VNM
| | - Tran Le Thi Thanh Nam
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, VNM
| | - Lam Thao Cuong
- Thoracic and Vascular Department, University Medical Center Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, VNM
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, VNM
| | - Ho Tat Bang
- Thoracic and Vascular Department, University Medical Center Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, VNM
- Department of Health Organization and Management, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, VNM
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Chen C, Cao J, Wang Y, Han X, Zhang Y, Zhuang S. Health-Related Quality of Life and Thyroid Cancer-Specific Symptoms in Patients Treated for Differentiated Thyroid Cancer: A Single-Center Cross-Sectional Survey from Mainland China. Thyroid 2023; 33:474-483. [PMID: 36792949 DOI: 10.1089/thy.2022.0490] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Background: The incidence of differentiated thyroid cancer in Mainland China has increased rapidly in recent years, yet the number of studies focusing on health-related quality of life (HR-QOL) is still limited. Additionally, some of the quality-of-life (QOL) issues specific to thyroid cancer have not been adequately described. The aims of this study were to assess the generic and disease-specific HR-QOL of differentiated thyroid cancer survivors and to identify the associated factors. Methods: A cross-sectional survey including 373 patients was conducted in Mainland China. Participants completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Thyroid Cancer-Specific Quality of Life Questionnaire (THYCA-QOL), and a questionnaire on patient demographics and clinical characteristics. Results: The QLQ-C30 global mean score was 73.12 (standard deviation [SD] = 11.95), while the THYCA-QOL summary mean score was 34.50 (SD = 12.68). The two QLQ-C30 functional subscales with the lowest scores were the social functioning and role functioning subscales. The five symptom subscales of the THYCA-QOL with the highest scores were the subscales regarding less interest in sex, problems with scar, psychological problems, voice problems, and sympathetic problems. Factors associated with worse global QOL on the QLQ-C30 included a shorter time since completing primary treatment (≤6 months), a history of lateral neck dissection, and a lower current thyrotropin (TSH) level (≤0.5 mIU/L). Higher cumulative activities of radioiodine (RAI; >100 mCi), gender (women), postoperative hypoparathyroidism, and a history of lateral neck dissection were associated with worse thyroid cancer-specific QOL. In contrast, higher monthly household income (>5000¥) and a history of minimally invasive thyroid surgery were associated with better thyroid cancer-specific QOL. Conclusions: Thyroid cancer patients experience multiple health-related problems and disease-specific symptoms after completing primary treatment. Patients with a duration ≤6 months from the completion of primary treatment, those with a history of lateral neck dissection, and a current TSH level ≤0.5 mIU/L may be more likely to have impaired generic QOL. More thyroid cancer-specific symptoms may be associated with higher cumulative activities of RAI, gender (women), postoperative hypoparathyroidism, a history of lateral neck dissection, lower monthly household income, and conventional surgery.
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Affiliation(s)
- Changlian Chen
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
- Basic Nursing Teaching and Research Office, School of Nursing, Tianjin Medical University, Tianjin, China
| | - Jiayan Cao
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Yueyang Wang
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Xuya Han
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Yaju Zhang
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Shumei Zhuang
- Basic Nursing Teaching and Research Office, School of Nursing, Tianjin Medical University, Tianjin, China
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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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Karcioglu AS, Dhillon VK, Davies L, Stack BC, Bloom G, Randolph G, Lango MN. Analysis of Unmet Information Needs Among Patients With Thyroid Cancer. JAMA Otolaryngol Head Neck Surg 2023; 149:110-119. [PMID: 36580287 PMCID: PMC9857628 DOI: 10.1001/jamaoto.2022.4108] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/23/2022] [Indexed: 12/30/2022]
Abstract
Importance Counseling prior to thyroid cancer (TC) treatment is an essential component of informed consent. An informed patient affects treatment-related expectations and patient engagement, factors that contribute significantly to patient-reported quality-of-life outcomes. Objective To describe experiences with pretreatment counseling among survivors of TC and to test factors associated with self-reported treatment meeting expectations. Design, Setting, and Participants A cross-sectional survey was administered between October 18, 2019, and February 8, 2020, to members of ThyCa: Thyroid Cancer Survivors' Association Inc, and to individuals accessing the public-facing ThyCa website. Survey respondents were asked 55 questions, including 4 free-text questions and 2 multiple-choice questions about pretreatment counseling. Main Outcomes and Measures Respondents self-reported (1) their unmet information needs, (2) rates of treatment meeting expectations, and (3) rates of treatment understanding. A mixed-methods analysis was performed, including qualitative content analysis of free-text responses and multivariable logistic regression of factors associated with self-reported levels of treatment meeting expectations. Results Of the 1412 survey respondents, 1249 were women (88.4%). The median age at diagnosis was 48 years (range, 18-85 years), and the median age at the time of survey completion was 60 years (range, 18-87 years). A total of 1259 respondents (89.2%) provided free-text responses to the question, "What would you tell someone newly diagnosed with your same condition?" Of these individuals, 526 (37.2%) reported inadequate pretreatment plan understanding and 578 (40.9%) reported that their treatment experience did not meet their expectations. Treatment met expectations for only 95 respondents (18.1%) reporting an inadequate pretreatment plan understanding. Of the 526 survivors of TC reporting a lack of understanding, 473 (90.0%) provided additional textual comments, most commonly in the categories of postoperative treatment, surveillance, and treatment effects. On multivariable logistic regression, self-reported failure to have an understanding of TC treatment was independently associated with failure of treatment to meet expectations (odds ratio, 5.1 [95% CI, 3.7-6.9]). Patients reporting a full understanding of their treatment plan were 5-fold more likely to indicate that their initial treatment experience was on par with expectations, independent of reported postoperative complications, age, sex, and other potential confounders. Conclusions and Relevance In this survey study, a substantial proportion of survivors of TC reported inadequate pretreatment understanding. This gap in understanding was associated with high levels of self-reported failure of treatment to meet expectations, which in turn is associated in other studies with poorer patient-reported quality-of-life outcomes. These outcomes may be improved by addressing gaps in patient understanding so expectations more closely match TC diagnosis and treatment pathways.
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Affiliation(s)
- Amanda Silver Karcioglu
- Division of Thyroid and Parathyroid Endocrine Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston
- Division of Otolaryngology–Head and Neck Surgery, NorthShore University HealthSystem, Evanston, Illinois
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Vaninder K. Dhillon
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Bethesda, Maryland
| | - Louise Davies
- Veterans Affairs Outcomes Group, Department of Veterans Affairs Hospital, White River Junction, Vermont
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
- Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire
| | - Brendan C. Stack
- Department of Otolaryngology–Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield
| | - Gary Bloom
- ThyCa: Thyroid Cancer Survivors’ Association Inc, Olney, Maryland
| | - Gregory Randolph
- Division of Thyroid and Parathyroid Endocrine Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Miriam N. Lango
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston
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KUPIK O, ŞEN B, ARPA M, AVCI U, GÜNDOĞDU H, KALCAN S, GÜÇER H, AKIN Ş, TUNCEL M. The effect of thyroid hormone withdrawal performed to evaluate the success of I-131 ablation on quality of life and psychological symptoms in female patients with low-risk differentiated thyroid cancer. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2023. [DOI: 10.32322/jhsm.1196968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Aim: There is a need to evaluate the treatment response in patients who have undergone radioiodine treatment (RIT) for differentiated thyroid cancer. Diagnostic tests that are used for this purpose include radioiodine whole-body scan (WBS) and serum thyroglobulin (Tg) measurement, which are most accurate during thyroid-stimulating hormone (TSH) stimulation. However, temporary discontinuation of thyroid hormone therapy to increase TSH (withdrawal) may be associated with the morbidity of hypothyroidism. The study aimed to show the effects of thyroid hormone withdrawal (THW) on quality of life and psychological symptoms in female patients with low-risk, well-differentiated papillary thyroid cancer. Methods: We applied the short form-36 (SF-36) and Symptom Checklist-90-R (SCL-90-R) questionnaires to the patients in the euthyroid state who have referred a median of 9 months (6-13 months) after RIT to perform a dWBS and to evaluate stimulated Tg. We applied the same questionnaire again when thyroid-stimulating hormone (TSH) was > 30 μIU/mL 4 weeks after THW (hypothyroid state). Results: 52 patients were evaluated (median age 48 years, range 23-65 years). There was a statistically significant worsening in anxiety, psychosis, additional items, and general symptoms of the SCL-90-R questionnaire, physical functioning, role limitation due to physical health, energy/fatigue, emotional well-being, social function, and general health change in the SF-36 questionnaire. Conclusions: THW worsened the patients’ psychological symptoms and quality of life. To reduce the side effects of hypothyroidism, treatment response assessment with TSH stimulation should be used only in a selected group of patients with a higher risk of recurrence.
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Affiliation(s)
- Osman KUPIK
- muğla sıtkı koçman üniv hastanesi, nükleer tıp bölümü
| | | | | | | | | | | | | | - Şafak AKIN
- UNIVERSITY OF HEALTH SCIENCES, GÜLHANE SCHOOL OF MEDICINE, GÜLHANE MEDICINE PR. (ANKARA)
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15
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Xu L, Cao ZX, Weng X, Wang CF. Global thyroid cancer incidence trend and age-period-cohort model analysis based on Global Burden of Disease Study from 1990 to 2019. Front Endocrinol (Lausanne) 2023; 14:1133098. [PMID: 37124740 PMCID: PMC10130642 DOI: 10.3389/fendo.2023.1133098] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/31/2023] [Indexed: 05/02/2023] Open
Abstract
Background In view of the rapid increase in the incidence of thyroid cancer (TC) and the spread of overdiagnosis around the world, the quantitative evaluation of the effect of age, period and birth cohort on the incidence of TC, and the analysis of the role of different factors in the incidence trend can provide scientific basis and data support for the national health departments to formulate reasonable prevention and treatment policies. Methods The study collated the global burden disease study data of TC incidence from 1990 to 2019, and used APC model to analyze the contribution of age, period and birth cohort to the incidence trend of TC. Results There was an obvious unfavorable upward trend in terms of age and cohort effect all over the world. Since 2007, the growth rate of risk slowed down and the risk in female even decreased since 2012, which mainly contributed to the developed countries. In all SDI countries, 2002 is the dividing point of risk between male and female. In 2019, The global age-standardized incidence rate (ASIR) of TC in the 5 SDI countries all showed a significant upward trend, with the largest upward trend in the middle SDI countries. Conclusion The trend of rapid increase in the incidence of TC has begun to slow down, but the global incidence of TC has obvious gender and regional/national heterogeneity. Policy makers should tailor specific local strategies to the risk factors of each country to further reduce the burden of TC.
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Affiliation(s)
- Le Xu
- Department of Head and Neck Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhe Xu Cao
- Department of Thyroid Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xin Weng
- Department of Pathology, The First Affiliated Hospital, Nanhua University, Hengyang, Hunan, China
| | - Can Fei Wang
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- *Correspondence: Can Fei Wang,
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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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Lee J, Lee YJ, Lim DJ, Lee JM, Chang SA, Kim MH. Quality of Life of Survivors of Thyroid Cancer Is Not Inferior to That in Subjects without Cancer: Long-Term after Over 5 Years. Endocrinol Metab (Seoul) 2022; 37:664-673. [PMID: 36065647 PMCID: PMC9449106 DOI: 10.3803/enm.2022.1499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/04/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGRUOUND Patients with thyroid cancer undergo less extensive surgery and additional therapies compared to those with other cancers. We aimed to compare the quality of life (QoL) between patients with thyroid cancer and healthy subjects using representative data from Korea. Differences in QoL of thyroid cancer survivors according to the duration after cancer diagnosis was also evaluated. METHODS This population-based cohort study included 50,278 subjects who participated in the Korea National Health and Nutrition Examination Survey between 2007 and 2017. QoL was compared between patients with thyroid cancer and healthy subjects using self-reported data from the EuroQoL (EQ)-5 dimension (5D) and EQ-visual analog scale (VAS). Propensity score matching was used to match thyroid cancer survivors to healthy subjects (1:5 matching). RESULTS Linear regression with univariate analysis showed that the presence of thyroid cancer was positively correlated with better EQ-5D index scores (β-coefficient=0.010, p=0.046). After adjusting for multiple covariables, statistical significance was maintained. EQ-VAS fails to demonstrate any significant correlation. Among the EQ-5D categories, patients with thyroid cancer showed better self-care than healthy subjects. Thyroid cancer duration did not correlate with the EQ-5D index score. In subgroup analyses, compared to patients with thyroid cancer duration of <5 years, no significant difference was observed in the correlation between the EQ-5D index score and survival duration in those with thyroid cancer duration of 5 to 9 years and ≥10 years. CONCLUSION Using a large-scale nationwide population-based database, our study demonstrated better QoL, especially in terms of self-care, among thyroid cancer survivors than among healthy subjects without cancer.
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Affiliation(s)
- Jeongmin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Youn-Ju Lee
- Division of Biostatistics, Medical Excellence Inc., Seoul, Korea
| | - Dong-Jun Lim
- Division of Endocrinology and Metabolism, Seoul St. Mary’s hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung-Min Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang-Ah Chang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Min-Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Corresponding author: Min-Hee Kim. Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 1021 Tongil-ro, Eunpyeong-gu, Seoul 03312, Korea Tel: +82-2-2030-4348, Fax: +82-2-2030-4641, E-mail:
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Ferrante M, Distefano G, Distefano C, Copat C, Grasso A, Oliveri Conti G, Cristaldi A, Fiore M. Benefits of Physical Activity during and after Thyroid Cancer Treatment on Fatigue and Quality of Life: A Systematic Review. Cancers (Basel) 2022; 14:cancers14153657. [PMID: 35954324 PMCID: PMC9367318 DOI: 10.3390/cancers14153657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/16/2022] [Accepted: 07/22/2022] [Indexed: 12/09/2022] Open
Abstract
Simple Summary The usefulness of physical activity in a preventive key is no longer in question, whereas sports therapy is assuming an increasingly important role in cancer rehabilitation. This review provides an overview on the effects of physical activity on fatigue, quality of life (QoL) and health-related quality of life (HRQoL) in patients with thyroid cancer diagnosis both during and after treatment, with a focus on sex. We found that the level of confidence in the available evidence is very low. Future studies are needed to understand which training programs are optimal, both in terms of beneficial effects and to avoid potential adverse responses, in addition to focusing on gender differences. Abstract Background: Several epidemiological studies have provided evidence of the usefulness of physical activity for cancer prevention, increased survival and quality of life (QoL), but no comprehensive review is available on the effects on thyroid cancer. The present systematic review provides an overview of the effects of physical activity on fatigue, QoL and health-related quality of life (HRQoL) in patients with thyroid cancer diagnosis both during and after treatment, with a focus on sex. Methods: A literature search was conducted in the PubMed and Scopus databases. We included studies investigating the impact of physical activity during and after thyroid cancer treatment, including fatigue, QoL and/or HRQoL among the outcomes. Review articles, conference papers, short communications and articles written in a language other than English articles were excluded. Study selection followed the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA). Two reviewers independently selected the studies and assessed their eligibility. The same two reviewers independently screened studies, extracted data and assessed the risk of bias. Outcomes of interest were fatigue, QoL and HRQoL. The Newcastle–Ottawa Scale was used to assess the quality of the selected studies. We compared the outcomes between groups of patients with subclinical hyperthyroidism undergoing a physical activity program and a sedentary group, evaluating the possible presence of sex differences. Results and Discussion: We found five studies eligible for inclusion in our review; only two were prospective studies including an exercise training program. One study was a quasi-experimental study with a non-equivalent control group. Three out of five studies comprised low-quality evidence with a high risk of bias. Conclusion: The level of confidence in the available evidence is very low. A close association between physical activity and fatigue, QoL and HRQoL in patients with thyroid cancer diagnosis with a focus on sex can neither be supported nor refuted. Future studies are needed to understand which training programs are optimal, both in terms of beneficial effects and to avoid potential adverse responses, in addition to focusing on gender differences. The protocol of this systematic review was registered with PROSPERO: CRD42022322519.
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Long-Term Health-Related Quality of Life Outcomes Following Thyroid Surgery for Malignant or Benign Disease: Deficits Persist in Cancer Survivors Beyond Five Years. World J Surg 2022; 46:2423-2432. [PMID: 35798990 PMCID: PMC9261884 DOI: 10.1007/s00268-022-06643-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Thyroid cancer diagnoses are increasing and treatment can lead to significant morbidity. Long-term health-related quality of life (HRQoL) in thyroid cancer is understudied and lacks reference populations. This study compares long-term HRQoL between patients with thyroid cancer or benign disease, following thyroid surgery. METHODS Patients undergoing thyroidectomy between 2000 and 2017 were identified from a pathology database. 696 participants (278 malignant, 418 benign) were invited to complete a validated disease-specific HRQoL tool, City of Hope-Thyroid Version. Propensity scores were used to adjust for demographic and clinical differences between cohorts. RESULTS 206 patients (102 malignant, 104 benign), 71% female, returned surveys a median of 6.5 (range 1-19) years after thyroidectomy. Of the cancer cohort, 95% had differentiated thyroid cancer and 83% remained disease-free. There were no significant differences in overall HRQoL scores between groups. In comparison to the benign cohort, cancer patients showed a significant detriment in the social subdomain score (OR 0.10-0.96, p = 0.017) but not in other subdomains (physical, psychological, spiritual). Female gender, increasing BMI and cancer recurrence were significantly associated with decreased overall HRQoL. Compared to the benign cohort, cancer patients reported more personal and family distress associated with diagnosis and treatment, increased future uncertainty, poorer concentration and greater financial burden. CONCLUSION Although no difference in overall HRQoL was found between patients undergoing thyroidectomy for benign or malignant disease, detriments in social well-being may persist many years after surgery. Thyroid cancer patients and their families may benefit from increased supports around the time of diagnosis and treatment.
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20
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Yang S, Xu X. Anxiety and quality of life among papillary thyroid cancer patients awaiting final pathology results after surgery. Endocrine 2022; 76:377-384. [PMID: 35113335 DOI: 10.1007/s12020-022-02996-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/22/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE There is a lack of research on short-term mental health and health-related quality of life (HRQoL) in thyroid cancer patients. This study aimed to assess the short-term anxiety level and HRQoL of patients during the early postoperative period while awaiting pathology results, and to explore the important factors associated with state anxiety. METHODS In this single-center cross-sectional study, 349 patients with papillary thyroid cancer were included. Anxiety and HRQoL were measured using the State-Trait Anxiety Inventory (STAI) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30), respectively. RESULTS In general, papillary thyroid cancer patients reported good quality of life with a mean global quality of life score of 75.69 ± 20.66 (on a scale of 0-100, where 100 means the best). There was no significant difference in HRQoL between the two groups, except regarding social functioning (p = 0.027). The anxiety levels of the two groups were similar; however, the state anxiety score (42.17 ± 12.52) was significantly higher than the trait anxiety score (40.69 ± 11.18) among patients in the non-FNA group (p = 0.023). Dyspnea, insomnia, QL, and trait anxiety were independent factors that affected state anxiety. CONCLUSION Patients with papillary thyroid cancer had good postoperative HRQoL and a significantly higher than usual level of state anxiety while awaiting pathology results. Symptoms of dyspnea and insomnia, global quality of life, and trait anxiety are important factors associated with state anxiety. Preoperative FNA results may moderate the change in anxiety level. These findings may help clinicians provide psychological support.
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Affiliation(s)
- Shijie Yang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiequn Xu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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21
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Li T, Zhang Z, Chen W, Yu S, Sun B, Deng X, Ge J, Wei Z, Lei S, Li G. Comparison of quality of life and cosmetic result between open and transaxillary endoscopic thyroid lobectomy for papillary thyroid microcarcinoma survivors: A single-center prospective cohort study. Cancer Med 2022; 11:4146-4156. [PMID: 35470574 DOI: 10.1002/cam4.4766] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 04/05/2022] [Accepted: 04/11/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Transaxillary endoscopic thyroidectomy has been introduced to achieve better cosmetic outcomes. However, the benefits of this technology on the patients' health-related quality of life (HRQoL) remain unclear. We aimed to investigate whether transaxillary endoscopic lobectomy is comparable to conventional open lobectomy in terms of QOL and cosmetic results in order to provide more evidence for establishing appropriate clinical decisions. METHODS Between August 2019 and May 2020, transaxillary endoscopic lobectomy and conventional open lobectomy were performed in 73 and 99 patients with papillary thyroid microcarcinoma, respectively. HRQoL was assessed at 1, 3, 6, and 12 months after surgery using the Thyroid Cancer-Specific Quality of Life Questionnaire. The cosmetic outcomes were assessed 12 months after surgery using the Patient and Observer Scar Assessment Scale (POSAS). RESULTS No significant difference was observed in the surgical results between the two groups. However, the data showed that the average operative time and postoperative hospital stay of the transaxillary group were longer than those of the open group (p < 0.001). Both groups showed similar changes in the QOL scores over time. However, the transaxillary group had fewer complaints of the throat or oral problems at 1 month postoperatively than the open group (p < 0.001). During the follow-up, the cosmetic results of scars in the transaxillary group were significantly better than those in the open group (p < 0.05). Patients who underwent transaxillary endoscopic lobectomy had higher overall satisfaction with their scar appearance, determined using POSAS, at 12 months postoperatively. CONCLUSIONS The current findings suggest that transaxillary endoscopic lobectomy may offer better cosmetic and HRQoL outcomes.
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Affiliation(s)
- Tingting Li
- Department of General Surgery & Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumor, Nanfang Hospital, The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhicheng Zhang
- Department of General Surgery & Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumor, Nanfang Hospital, The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Weisheng Chen
- Department of General Surgery & Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumor, Nanfang Hospital, The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Shitong Yu
- Department of General Surgery & Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumor, Nanfang Hospital, The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Baihui Sun
- Department of General Surgery & Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumor, Nanfang Hospital, The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiangqian Deng
- Department of General Surgery & Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumor, Nanfang Hospital, The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Junna Ge
- Department of General Surgery & Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumor, Nanfang Hospital, The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhigang Wei
- Department of General Surgery & Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumor, Nanfang Hospital, The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Shangtong Lei
- Department of General Surgery & Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumor, Nanfang Hospital, The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Guoxin Li
- Department of General Surgery & Guangdong Provincial Key Laboratory of Precision Medicine for Gastrointestinal Tumor, Nanfang Hospital, The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
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22
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Yang S, Xu X. Mental Health in Postoperative Thyroid Patients During the COVID-19 Pandemic. Front Endocrinol (Lausanne) 2022; 13:875325. [PMID: 35837317 PMCID: PMC9274260 DOI: 10.3389/fendo.2022.875325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Little is known about mental health in patients after thyroid surgery during the peak of the COVID-19 pandemic in China. This study aimed to assess the mental health of postoperative thyroid patients and to explore potential factors associated with psychological symptoms. METHODS In this study, we surveyed 241 patients who underwent thyroid surgery at Peking Union Medical College Hospital. Insomnia, anxiety, depression, and posttraumatic stress symptoms (PTSS) were measured using the Insomnia Severity Index (ISI), Generalized Anxiety Disorder Questionnaire (GAD-7), Patient Health Questionnaire (PHQ-9), and Impact of Event Scale-Revised (IES-R), respectively. RESULTS A significant proportion of postoperative patients reported experiencing insomnia, anxiety, depression, and PTSS. Patients that were older, single/divorced/widowed, and less educated; had lower income and poor general health; had undergone surgery within the past six months; had disrupted follow-up, and; searched social media for COVID-19-related information were associated with worse mental health. CONCLUSIONS During the COVID-19 pandemic, postoperative thyroid patients tended to develop mental health problems and have less psychological support, emphasizing the importance of patient education and psychological interventions.
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Affiliation(s)
| | - Xiequn Xu
- *Correspondence: Xiequn Xu, ; orcid.org/0000-0003-0347-5258
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23
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Chen JJ, Tsai LY, Tsai JM, Hsu CY. Food Away From Home and Self-Perceived Gastrointestinal Health. Front Nutr 2021; 8:741647. [PMID: 34901106 PMCID: PMC8662982 DOI: 10.3389/fnut.2021.741647] [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: 07/15/2021] [Accepted: 09/20/2021] [Indexed: 01/30/2023] Open
Abstract
Dietary behavior is a critical lifestyle factor affecting health. This study aimed to investigate food away from home (FAFH) and its effect on gastrointestinal (GI) health. A questionnaire-based survey was conducted with 300 participants at a hospital in Liouying, Taiwan. The survey collected demographic information and data on FAFH and GI health. The association of GI health with FAFH consumption behavior was significant (t-test, p < 0.05). Bodyweight status was associated with age (F = 5.01, p = 0.01), dietary situation (F = 1.96, p = 0.04), number of meals (F = 1.85, p = 0.03), dietary preferences (F = 2.84, p = 0), reasons for FAFH (F = 1.86, p = 0.02), FAFH types (F = 2.01, p = 0), and outcomes associated with FAFH (F = 2.51, p = 0). Gastrointestinal condition was associated with the number of meals (F = 2.55, p = 0), the level of activity after meals (F = 2.16, p = 0.02), and FAFH type (F = 1.48, p = 0.04). The results indicated that the participants aged 20–40 years had more problems related to their self-perceived body weight status than those aged 41–50 years. The results of this study clarify the FAFH among people in Taiwan and the effects on GI health and may serve as a reference for relevant behavioral research in food and health studies.
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Affiliation(s)
- Jyh-Jou Chen
- Gastroenterology and Hepatology Department, Chi-Mei Medical Center, Tainan, Taiwan.,College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan
| | - Li-Yun Tsai
- College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan
| | - Jung-Mei Tsai
- College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan.,Mackay Memorial Hospital, Taipei City, Taiwan.,Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei City, Taiwan.,Department of Nursing, Mackay Medical College, New Taipei City, Taiwan
| | - Chen-Yuan Hsu
- College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan
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24
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Liu YH, Jin J, Liu YJ. Machine learning-based random forest for predicting decreased quality of life in thyroid cancer patients after thyroidectomy. Support Care Cancer 2021; 30:2507-2513. [PMID: 34782918 DOI: 10.1007/s00520-021-06657-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/24/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Decreased quality of life (QoL) in thyroid cancer patients after thyroidectomy is a common, but there is a lack of predictive methods for decreased QoL. This study aimed to construct a machine learning-based random forest for predicting decreased QoL in thyroid cancer patients 3 months after thyroidectomy. MATERIALS AND METHODS Two hundred and eighty-six thyroid cancer patients after thyroidectomy were enrolled in this prospective cross-sectional study from November 2018 to June 2019, and were randomly assigned to training and validation cohorts at a ratio of 7:3. The European Organization for Research and Treatment of Cancer quality of life questionnaire version 3 (EORTC QLQ-C30) questionnaire was used to assess the QoL 3 months after thyroidectomy, and decreased QoL was defined as EORTC QLQ-C30 < 60 points. The random forest model was constructed for predicting decreased QoL in thyroid cancer patients after thyroidectomy. RESULTS The mean QoL 3 months after thyroidectomy was 65.93 ± 9.00 with 21.33% (61/286) decreased QoL. The main manifestation is fatigue in symptom scales and social functioning dysfunction in functional scales. The top seven most important indices affecting QoL were clinical stage, marital status, histological type, age, nerve injury symptom, economic income and surgery type. For random forest prediction model, the areas under the curve in the training and validation courts were 0.834 and 0.897, respectively. CONCLUSION The present study demonstrated that random forest model for predicting decreased QoL in thyroid cancer patients 3 months after thyroidectomy displayed relatively high accuracy. These findings should be applied clinically to optimise health care.
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Affiliation(s)
- Yong Hong Liu
- Department of Breast Surgery, The Fourth Hospital of Hebei Medical University, No. 169 Tianshan Street, Shijiazhuang City, 050011, China
- Thyroid and Breast Surgery, Cangzhou Central Hospital, No. 16 Xinhua Road, Yunhe Qu, Cangzhou City, 061000, China
| | - Jian Jin
- Thyroid and Breast Surgery, Cangzhou Central Hospital, No. 16 Xinhua Road, Yunhe Qu, Cangzhou City, 061000, China
| | - Yun Jiang Liu
- Department of Breast Surgery, The Fourth Hospital of Hebei Medical University, No. 169 Tianshan Street, Shijiazhuang City, 050011, China.
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25
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Yang S, Wang J, Xu X. Psychological health status among thyroid cancer patients during the COVID-19 epidemic in China. Support Care Cancer 2021; 30:2111-2119. [PMID: 34671859 PMCID: PMC8528476 DOI: 10.1007/s00520-021-06624-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/08/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To investigate the psychological health status and explore the impact of different factors among thyroid cancer patients during the peak period of the COVID-19 epidemic in China. METHODS With thyroid cancer patients who had attended Peking Union Medical College Hospital included, we collected their demographic and clinical characteristics, COVID-19-related factors, and outcomes of 4 psychological scales (Insomnia Severity Index [ISI], Generalized Anxiety Disorder Questionnaire [GAD-7], Patient Health Questionnaire [PHQ-9], and Impact of Events Scale-Revised [IES-R]) through an online questionnaire and used multiple linear regression to find independent risk factors for each psychological symptom. RESULTS A total of 219 patients were included. Insomnia, anxiety, depression, and clinically relevant post-traumatic stress symptoms (PTSS) were reported by 69 (31.5%), 87 (39.7%), 74 (33.8%), and 44 (20.1%) patients, respectively. Based on multiple linear regression, being single/divorced/widowed, having a lower level of education, receiving resources of science lectures during the epidemic, and experiencing disruption of routine treatment or follow-up were associated with poorer psychological health among patients with thyroid cancer. CONCLUSIONS High rates of psychological symptoms and potential risk factors were found in thyroid cancer patients during the peak period of COVID-19 in China. Based on these findings, the psychological status of these patients should be a focus, and the psychological support systems need to be strengthened for the prevention of psychological crises during the epidemic.
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Affiliation(s)
- Shijie Yang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinhui Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiequn Xu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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26
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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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28
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Lan Y, Jin Z, Zhang Y, Song Q, Xiao J, Yan L, Zhu Y, Zhang M, Luo Y. Factors associated with health-related quality of life in papillary thyroid microcarcinoma patients undergoing radiofrequency ablation: a cross-sectional prevalence study. Int J Hyperthermia 2021; 37:1174-1181. [PMID: 33043742 DOI: 10.1080/02656736.2020.1812738] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To explore the association of demographic characteristics, clinical symptoms and the fear of the disease progression factors with the physical and mental summary components of the health-related of life (HRQoL) of the papillary thyroid microcarcinoma (PTMC) patients undergoing radiofrequency ablation (RFA). METHODS 123 PTMC survivors undergoing RFA were enrolled in this study from October 2019 to March 2020. Demographic, clinical symptoms and the fear of the disease progression data were collected. SF-36, THYCA-QoL and FoP-Q-SF were used to evaluate the HRQoL of patients, clinical symptoms and the fear of disease progression. A multivariate regression model was performed to evaluate the association between the independent variable and the HRQoL variable. RESULTS The average self-reported HRQoL score was 81.17 ± 15.48 for the PCS and 73.40 ± 18.03 for the MCS. The multivariate linear regression model shows that the factors related to a poorer PCS were dependent for the female patients, the symptoms of neuromuscular and the throat/mouth, the fear of disease progression; the psychological disorder, symptoms of throat/mouth, inability to concentrate were related to worse scores for the MCS. The condition that was most strongly related to a poorer HRQoL (in both PCS and MCS) was the fear of their physical health. CONCLUSIONS The factors related to significantly worse HRQoL scores across PCS and MCS for PTMC survivors include the female gender, the symptoms of neuromuscular and the throat/mouth, the psychological disorder, inability to concentrate, and the fear of their own physical health. Identification, management, and prevention of these factors are critical to improving the HRQoL of patients.
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Affiliation(s)
- Yu Lan
- School of Medicine, Nankai University, Tianjin, China.,Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, China.,Department of Ultrasound, The People's Hospital of Liaoning Province, Shenyang, China
| | - Zhuang Jin
- Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, China.,Department of Ultrasound, General Hospital of Northern Military Area, Shenyang, China
| | - Yan Zhang
- Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Qing Song
- Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jing Xiao
- School of Medicine, Nankai University, Tianjin, China.,Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Lin Yan
- Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yaqiong Zhu
- School of Medicine, Nankai University, Tianjin, China.,Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Mingbo Zhang
- Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yukun Luo
- School of Medicine, Nankai University, Tianjin, China.,Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, China
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29
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Shao L, Chen X, Lyu J, Zhao M, Li Q, Ji S, Sun Q, Tang D, Geng H, Guo M. Enrichment and Quantitative Determination of Free 3,5- Diiodothyronine, 3',5'-Diiodothyronine, and 3,5-Diiodothyronamine in Human Serum of Thyroid Cancer by Covalent Organic Hyper Cross-linked Poly-ionic Liquid. J Chromatogr A 2020; 1637:461821. [PMID: 33360433 DOI: 10.1016/j.chroma.2020.461821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/09/2020] [Accepted: 12/14/2020] [Indexed: 01/08/2023]
Abstract
The incidence of thyroid cancer is increasing worldwide. So far, still no non-invasive clinical test biomarkers were developed for the diagnosis of thyroid cancer. The diiodothyronines (T2s) are precursors and metabolites of thyroid hormone (T4). Some reports predict that T2s may be associated with several thyroid diseases, especially the thyroid cancer. Detecting free T2s in human serum may help the diagnosis of thyroid cancer. However, few works have reported the detection of T2s due to their trace amounts. Here we developed a novel hyper organic cross-linked poly ionic liquid (PIL) material for the enrichment of three main compounds in T2s family, including 3,5- diiodothyronine (3,5-T2), 3',5'-diiodothyronine (3',5'-T2), and 3,5-diiodothyronamine (3,5-T2AM). This PIL material provided specific enrichment superiority for three T2s. After enrichment, the signal intensity of 3,5-T2, 3',5'-T2, and 3,5-T2AM increased 14, 132 and 1.6 folds, respectively, with LOQ of 76, 87, and 107 fM, respectively. Finally, we successfully applied PIL material coupled with HPLC-ESI-MS/MS in enrichment and quantitative determination of free 3,5-T2, 3',5'-T2, and 3,5-T2AM in human serum of 45 thyroid cancer patients and 15 healthy people. We also used free thyroid hormone (FT4) as the calibration reference to eliminate individual differences. We found that the levels of 3,5-T2 (P < 0.001), and 3',5'-T2 (P = 0.001) in patients with thyroid cancer were significantly higher than those in healthy people. Additionally, we further investigated the power of different T2 thyroid hormones divided FT4 to classify thyroid cancer patients and healthy people. And 3,5-T2/FT4 had the highest classification performance for discriminating thyroid cancer patients from healthy people at certain threshold, indicating that 3,5-T2/FT4 in human serum can act as potential biomarkers for "non-invasive" clinical diagnosis of thyroid cancer.
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Affiliation(s)
- Lili Shao
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Xi Chen
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Jinxiu Lyu
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Meng Zhao
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Qing Li
- Xuzhou Central Hospital, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Shuai Ji
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Qiang Sun
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Daoquan Tang
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Houfa Geng
- Xuzhou Central Hospital, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China.
| | - Mengzhe Guo
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China.
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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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31
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Roth EM, Lubitz CC, Swan JS, James BC. Patient-Reported Quality-of-Life Outcome Measures in the Thyroid Cancer Population. Thyroid 2020; 30:1414-1431. [PMID: 32292128 PMCID: PMC7583324 DOI: 10.1089/thy.2020.0038] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background: There is an escalating worldwide population of thyroid cancer (TC) survivors. In addition to conventional metrics of quality of care, quality-of-life (QoL) assessment in TC patients is imperative. TC survivors face unique impediments to health-related quality of life (HRQoL), including thyroid-specific symptoms and exposure to disease-related stressors-including fear of recurrence and financial toxicity-over a prolonged survival period. Survey instruments currently used to assess HRQoL in TC survivors may be insufficient to accurately capture the burden of disease in this population. We aimed to identify the HRQoL instruments in the literature, which have been applied in the TC survivor population, and to present the psychometric properties of the scales and indexes that have been used. We hypothesized that few instruments have shown evidence of validity in this population. Summary: Of the 927 articles identified by search criteria, only 28 studies using 15 HRQoL instruments met inclusion criteria. Of the 15 HRQoL instruments identified, 9 were psychometric health status instruments and 6 were preference-based indexes, but none had been validated in the TC survivor population. While the majority of reviewed studies demonstrated impaired psychological and emotional well-being in TC survivors, these findings were not uniformly demonstrated across studies, and the longevity of the impact of TC on HRQoL was variably reported. Conclusions: Discrepancies in the literature regarding the impact of TC survivorship on HRQoL emphasize the challenges of accurately assessing patient perspectives, reinforcing the importance of using well-constructed instruments to measure patient-reported outcomes in the target population. Care providers involved in the treatment of TC survivors should be aware of longitudinal effects on HRQoL, especially pertaining to chronic psychological debilitation. Further development and rigorous validation of TC-specific instruments will allow for better data gathering and understanding of the barriers to achieving high long-term HRQoL in TC survivors throughout their long postsurvival course.
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Affiliation(s)
- Eve M. Roth
- Harvard Medical School, Boston, Massachusetts, USA
| | - Carrie C. Lubitz
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - John Shannon Swan
- Harvard Medical School, Boston, Massachusetts, USA
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Benjamin C. James
- Harvard Medical School, Boston, Massachusetts, USA
- Section of Endocrine Surgery, Division of Surgical Oncology, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Address correspondence to: Benjamin C. James, MD, MS, FACS, Section of Endocrine Surgery, Division of Surgical Oncology, Department of Surgery, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Palmer 605, Boston, MA 02215, USA
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32
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Liu Y, Lai F, Long J, Peng S, Wang H, Zhou Q, Li B, Su L, Gan L, Shi Y, Lv W, Li Y, Cheng K, Xiao H. Screening and the epidemic of thyroid cancer in China: An analysis of national representative inpatient and commercial insurance databases. Int J Cancer 2020; 148:1106-1114. [PMID: 32930403 PMCID: PMC7821127 DOI: 10.1002/ijc.33298] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/21/2020] [Accepted: 09/08/2020] [Indexed: 12/29/2022]
Abstract
Reasons behind the rapid increase of thyroid cancer (TC) in China are uncertain. We assessed the burden of TC and the role of access to screening and salt iodization. We analyzed two national databases in China: Hospital Quality Monitoring System (HQMS) and China Reinsurance Company (CRC) database. HQMS covered 1037 (44.3%) Class 3 hospitals and 76 263 617 Class 3 hospital inpatients in 2013 to 2017 and CRC covered 93 123 018 clients in 2000 to 2016. The proportion of TC inpatients among inpatients in HQMS and TC incidence in critical illness insurance buyers were used to evaluate the association with screening and iodine status. Between 2013 and 2017, the proportion of TC patients in HQMS with urban employee medical insurance and good access to screening increased sharply while there was little change among those with the other two forms of medical insurance. Across provinces, the proportion of TC inpatients in HQMS was positively correlated with per capita disposable income but not with median urinary iodine. Similar findings were observed in the CRC database. In 2017, approximately 1000 individuals were overdiagnosed with TC daily. We conservatively forecast that 5.1 million healthy individuals would become TC patients unnecessarily between 2019 and 2030. Our findings suggested the epidemic of TC in China was substantially underestimated. It was associated with screening but not with salt iodization. What's new? In recent decades, the incidence of thyroid cancer has increased rapidly worldwide. In China, the role of thyroid cancer screening as part of regular health checks and potential overdiagnosis remain unclear. Moreover, there are concerns among the general public that mandatory salt iodization may have contributed to the epidemic of thyroid cancer. Here, the authors found that the increase in thyroid cancer in China is associated with increased access to health care and screening, but not with salt iodization. Moreover, the results suggest that approximately 1000 individuals are overdiagnosed with thyroid cancer daily, calling for urgent measures to prevent overdiagnosis.
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Affiliation(s)
- Yihao Liu
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Fenghua Lai
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jianyan Long
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Sui Peng
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Haibo Wang
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qian Zhou
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Bin Li
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lei Su
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lanxia Gan
- China Standard Medical Information Research Center, Shenzhen, China
| | - Ying Shi
- China Standard Medical Information Research Center, Shenzhen, China
| | - Weiming Lv
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yanbing Li
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Karkeung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Haipeng Xiao
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Papaleontiou M, Evron JM, Esfandiari NH, Reyes-Gastelum D, Ward KC, Hamilton AS, Worden F, Haymart MR. Patient Report of Recurrent and Persistent Thyroid Cancer. Thyroid 2020; 30:1297-1305. [PMID: 32183609 PMCID: PMC7482108 DOI: 10.1089/thy.2019.0652] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background: Despite the excellent survival of most patients with differentiated thyroid cancer (DTC), recurrent and persistent disease remain major concerns for physicians and patients. However, studies on patient report of recurrent and persistent disease are lacking. Methods: Between February 1, 2017, and October 31, 2018, we surveyed eligible patients who were diagnosed with DTC between 2014 and 2015 from the Georgia and Los Angeles Surveillance, Epidemiology, and End Results cancer registries (N = 2632; response rate, 63%). Patients who reported current disease status were included in this study (n = 2454). Patient-reported data were linked to registry data. A multivariable, multinomial logistic regression analysis was conducted to determine patient and tumor characteristics associated with recurrent and persistent thyroid cancer. Quality of life was evaluated using the Patient-Reported Outcomes Measurement Information System-Global Health v1.2 questionnaire. Meaningful change in global health was defined as a minimal difference of a half standard deviation or 5 points compared with the mean (T score = 50) of a sample population matching the United States 2000 General Census. Results: Of the 2454 patients completing the survey, 95 (4.1%) reported recurrent disease and 137 (5.8%) reported persistent disease. In multinomial analyses, T3/T4 classification and cervical lymph node involvement (N1) were associated with both report of recurrent (adjusted relative risk ratio [RRR] 1.99, 95% confidence interval [CI 1.16-3.42]; adjusted RRR 2.03 [CI 1.29-3.21], respectively) and persistent disease (adjusted RRR 3.48 [CI 1.96-6.20]; adjusted RRR 3.56 [CI 2.41-5.24], respectively). Additionally, Hispanic ethnicity was associated with report of recurrent disease (adjusted RRR 1.99 [CI 1.23-3.24]). Regarding quality of life, the median scores in patients with persistent disease met criteria for meaningful change in global physical health (T-score = 44.9) and global mental health (T-score = 43.5) when compared with the general population norms. Median scores in patients with cured or recurrent disease did not meet criteria for meaningful change. Conclusions: Patient report is a reasonable method of assessing recurrent and persistent disease. Impact on quality of life is more marked for patients with reported persistent disease. Our findings will help personalize treatment and long-term follow-up in these patients.
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Affiliation(s)
- Maria Papaleontiou
- Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Josh M. Evron
- Division of Endocrinology and Metabolism, Department of Internal Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Nazanene H. Esfandiari
- Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - David Reyes-Gastelum
- Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Kevin C. Ward
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Ann S. Hamilton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Francis Worden
- Division of Hematology and Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Megan R. Haymart
- Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
- Address correspondence to: Megan R. Haymart, MD, Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, North Campus Research Complex, 2800 Plymouth Road, Building 16, Room 408E, Ann Arbor, MI 48109
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Looking under the hood of "the Cadillac of cancers:" radioactive iodine-related craniofacial side effects among patients with thyroid cancer. J Cancer Surviv 2020; 14:847-857. [PMID: 32506220 DOI: 10.1007/s11764-020-00897-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 05/13/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Despite having a generally favorable prognosis, differentiated thyroid cancer is known to have a significant, long-term impact on the quality of life of survivors. We wished to investigate short- and long-term effects among thyroid cancer survivors following radioactive iodine therapy. METHODS We conducted eight focus groups (N = 47) to understand patients' experiences of short- and long-term effects after radioactive iodine treatment and the impact these treatment-related side effects had on patients' quality of life. We elicited responses regarding experiences with side effects following radioactive iodine treatment, particularly salivary, lacrimal, and nasal symptoms. We transcribed audiotapes and conducted qualitative analyses to identify codes and themes. RESULTS We identified eight broad themes from the qualitative analyses. Themes reflecting physical symptoms included dry mouth, salivary gland dysfunction, altered taste, eye symptoms such as tearing or dryness, and epistaxis. Psychosocial themes included lack of knowledge and preparation for treatment, regret of treatment, and distress that thyroid cancer is labeled as a "good cancer." CONCLUSIONS Thyroid cancer survivors reported a wide range of radioactive iodine treatment-related effects and psychosocial concerns that appear to reduce quality of life. The psychosocial concerns reported by participants underscore the significant unmet information and support needs prior to and following RAI treatment among individuals diagnosed with thyroid cancer. IMPLICATIONS FOR CANCER SURVIVORS Future research is needed to help both patients and physicians understand the effect of radioactive iodine on quality of life, and to better assess the benefits versus the risks of radioactive iodine therapy.
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Li J, Pang H, Sun Z, Zhao L, Bai C. Health status of middle-aged and older cancer survivors: a nationwide cross-sectional study from the China Health and Retirement Longitudinal Study (CHARLS). ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:183. [PMID: 32309330 PMCID: PMC7154473 DOI: 10.21037/atm.2020.01.105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background The number of Chinese cancer survivors has increased bolstered by the combined trends of an aging population and improved cancer survival; however, related research on cancer survivorship remains limited. Therefore, this study aimed to provide an overview of the health status of middle-aged and older cancer survivors in China. Methods We used the cross-sectional self-reported survey data from wave 4 in the China Health and Retirement Longitudinal Study (CHARLS). A total of 354 cancer survivors and 16,664 participants without cancer were identified from CHARLS. Physical and mental health, health behavior, and health care information collected by questionnaire were compared between these two groups. Results Compared with the general middle-aged and older population, cancer survivors had more concomitant chronic diseases (2.75 vs. 2.00, P<0.001). In addition, cancer survivors were found to be more statistically likely to have difficulties with activity (3.53 vs. 2.39, P<0.001) and have depressive symptoms (10.07 vs. 8.01, P<0.001) compared with participants without cancer. Also, cancer survivors were less likely to drink compared to those without a cancer diagnosis (OR 0.49; 95% CI, 0.36–0.66, P<0.001), but smoking behavior and physical activity did not show a significant difference. Coexisting chronic diseases and smoking harmed the physical and mental health of middle-aged and older people. We also found that cancer survivors had higher medical care expenses when compared with participants without cancer. Conclusions Cancer survivors older than 45 years in China have poorer outcomes in comorbidities and physical and mental health than their age-matched individual counterparts without cancer. Therefore, a higher quality and more cost-effective supportive care for these individuals is needed.
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Affiliation(s)
- Jiarui Li
- Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100032, China
| | - Haiyu Pang
- Central Research Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Zhao Sun
- Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100032, China
| | - Lin Zhao
- Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100032, China
| | - Chunmei Bai
- Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100032, China
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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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Wei ZL, Gao AB, Wang Q, Lou XE, Zhao J, Lu QJ. MicroRNA-221 promotes papillary thyroid carcinoma cell migration and invasion via targeting RECK and regulating epithelial-mesenchymal transition. Onco Targets Ther 2019; 12:2323-2333. [PMID: 30992669 PMCID: PMC6445232 DOI: 10.2147/ott.s190364] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aim The aim of this study was to detect the effects and potential mechanisms of microRNA-221 on a series of biological behaviors of papillary thyroid carcinoma (PTC) cells in vitro and in vivo. Methods First, we analyzed the relationship between the expression of miR-221 and several clinicopathological features of PTC patients and then detected the expression of the miR-221 in tumor tissues and cell lines. The effects of miR-221 on proliferation and invasion of PTC cells were verified by cell counting kit-8 (CCK-8) assay, wound healing assay and transwell assay. Western blot assay was applied to explore the correlation between miR-221 and RECK expression in PTC K1 cells. Finally, a xenograft model was established to further confirm the tumor-promoting effects of miR-221 in vivo. Results Our data indicated that miR-221 was relatively upregulated in metastatic PTC tissues. MiR-221 promoted the proliferation, migration and invasion activities of PTC K1 cells, following variations of epithelial-mesenchymal transition (EMT)-related protein expression. We identified RECK as a direct target of miR-221, revealed its expression to be inversely correlated with miR-221 in PTC samples and showed that its reintroduction reverses miR-221-induced PTC invasiveness. In addition, miR-221 was also verified to promote tumor growth and increase tumor volume and weight in vivo. Taken together, miR-221/RECK axis could be an effective way to regulate biological behaviors of PTC. Conclusion MiR-221 may be involved in PTC cell invasion and metastasis by targeting RECK, indicating that the miR-221/RECK pathway could be studied further as a potential new diagnostic or prognostic biomarker for PTC.
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Affiliation(s)
- Zhao-Li Wei
- Department of Endocrinology, Binzhou Central Hospital, Binzhou Medical University, Binzhou 251700, Shandong Province, People's Republic of China
| | - Ai-Bin Gao
- Department of Endocrinology, Binzhou Central Hospital, Binzhou Medical University, Binzhou 251700, Shandong Province, People's Republic of China
| | - Qing Wang
- Department of Endocrinology, Binzhou Central Hospital, Binzhou Medical University, Binzhou 251700, Shandong Province, People's Republic of China
| | - Xiu-E Lou
- Department of Endocrinology, Binzhou Central Hospital, Binzhou Medical University, Binzhou 251700, Shandong Province, People's Republic of China
| | - Jing Zhao
- Department of Oncology, Provincal Hospital of Shandong University, Jinan 250000, Shandong Province, People's Republic of China
| | - Qing-Jun Lu
- Department of Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200001, People's Republic of China,
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