Increases in thyroid nodule fine-needle aspirations, operations, and diagnoses of thyroid cancer in the United States. The overall quality of included studies was relatively homogenous according to study type and ranged from intermediate to high. Thyroid cancer patients who underwent thyroid surgery at any one of 14 different treatment centers in Europe were evaluated for post-surgery permanent low parathyroid hormone levels. Fear of recurrence, breast-conserving surgery, and the trade-off hypothesis. Researchers evaluated the incidence of physical, psychological, and lifestyle effects among patients withdifferentiated thyroid cancer. Lins L., Carvalho F.M. For empirical studies using quantitative methodology, we included any studies comparing preoperative HrQoL with postoperative HrQoL, postoperative HrQoL with healthy controls, postoperative HrQoL with active surveillance, or postoperative HrQoL following TT vs. HT. According to the results of this study, patients diagnosed with DTC report wide-ranging HrQoL issues; these seem more prevalent among patients who undergo total thyroidectomies (with or without neck dissection) rather than hemithyroidectomies. Teliti et al. This finding is consistent withand may also be explained bythe greater impairment in physical-related HrQoL that was observed in TT patients compared with HT patients. Perceived lack of support among young thyroid cancer survivors. Overall and cause-specific survival for patients undergoing lobectomy, near-total, or total thyroidectomy for differentiated thyroid cancer. Another study found a transitory impairment in voice quality following surgery, which decreased with time until there was, on average, no more vocal impairment at one year following surgery [70]. Quality of life in papillary thyroid microcarcinoma patients undergoing radiofrequency ablation or surgery: A comparative study. Chan S., Karamali K., Kolodziejczyk A., Oikonomou G., Watkinson J., Paleri V., Nixon I., Kim D. Systematic review of recurrence rate after hemithyroidectomy for low-risk well-differentiated thyroid cancer. So far, the psychological aspect of HrQoL in DTC patients has been poorly studied, with the majority of existing research focusing on the physical aspects of the disease and related treatments [81]. Strategies to deal with confounders were stated? Doubleday A.R., Robbins S.E., Macdonald C.L., Elfenbein D.M., Connor N.P., Sippel R.S. The fact that psychological-related HrQoL did not decrease but increased in some studies following surgery compared with preoperative time points further supports this hypothesis. Two studies compared the social-related HrQoL of patients undergoing surgery versus AS and found a significant decrease in the social subscale (n = 4), social functioning (n = 1), and role limitations due to physical or emotional health (n = 1) [54,67]. Q7. Despite DTC patients life expectancy being similar to that of the general population, their HrQoL may be impaired for up to 20 years following curative treatment [15,16,17,18,19]. Any time you do a total thyroidectomy, your patient needs to take supplemental hormones for the rest of their life, said Umbricht. Over the last 50 years, the incidence of thyroid cancer has more than tripled in the United States, with mortality rates remaining largely stable over the last three decades [1,2]. The 5-Level EQ-5D (EQ-5D-5L) is a questionnaire comprised of 25 items and a visual analog scale (VAS) used in economic evaluations [30]. The European Organisation for Research and Treatment of Cancers Core Quality of Life Questionnaire (EORTC QLQ-C30) is a 30-item instrument designed to evaluate HrQoL in cancer patients [39]. Global PSQI scores range from 0 to 21, where lower scores denote better sleep quality [47]. Such people will have to take very large amounts of calcium every day after surgery, often for the rest of their lives. Billewicz W.Z., Chapman R.S., Crooks J., Day M.E., Gossage J., Wayne E., Young J.A. The Health Utilities Indexes 2 and 3 (HUI2 and HUI3) are 40-item health-status classification systems used in economic evaluations [33]. SF-36 total score as a single measure of health-related quality of life: Scoping review. One study found decreased general health in TT patients [59] The remaining two studies observed transitory impairments in global HrQoL in TT patients compared to HT patients, which subsided with time (6 months and 1 year postoperatively, respectively) [67]. Confounding factors were identified? The site is secure. Addressing postoperative HrQoL when discussing therapeutic options with patients is an integral part of patient-centered care and informed shared decision-making, and should be approached in a holistic manner, accounting for its physical, psychological, and social aspects. Outcomes were measured in a valid and reliable way? Q8. These patients are expected to experience an entirely different set of challenges postoperatively, whether it is regarding the fear of cancer recurrence, the necessity for medical appointments, RAI ablation or external beam radiation therapy, or attitudes towards potential postoperative complications. K. Kovatch and others. Some people with low calcium levels will have bad side effects, like numbness and tingling in their hands, feet and around their mouths, serious muscle cramps and even full body seizures. When this is done by a surgeon who specializes in this kind of surgery, thyroid surgery is safe and effective. One study found a significant increase in mental fatigue 2 years following TT, although anxiety and depression were decreased, and general mental health was improved 4 years following surgery [68]. In total, 23 different HrQoL instruments were used across included studies. Quality of life in patients with low-risk papillary thyroid microcarcinoma: Active surveillance versus immediate surgery. Quality assessment of mixed-methods or qualitative studies. Joanna Briggs Institute Critical Appraisal Tools. An empirical evaluation of the SF-12, SF-6D, EQ-5D and Michigan hand outcome questionnaire in patients with rheumatoid arthritis of the hand. Four of these studies found decreased physical-related HrQoL following TT compared with HT for at least one of the following items: global physical subscale (n = 1), voice symptoms (n = 1), sensory symptoms (n = 1), neuromuscular symptoms (n = 1), vitality (n = 1), and problems with scar (n = 1) [57,59,64,67]. Javaloyes N., Crespo A., Redal M.C., Brugarolas A., Botella L., Escudero-Ortiz V., Sureda M. Psycho-oncological intervention through counseling in patients with differentiated thyroid cancer in treatment with radioiodine (counthy, NCT05054634): A non-randomized controlled study. Jeon M.J., Lee Y.M., Sung T.Y., Han M., Shin Y.W., Kim W.G., Kim T.Y., Chung K.W., Shong Y.K., Kim W.B. Thyroid surgery is usually safe but adverse events can occur. Haigh P.I., Urbach D.R., Rotstein L.E. Herdman M., Gudex C., Lloyd A., Janssen M., Kind P., Parkin D., Bonsel G., Badia X. Purpose: Patients with thyroid cancer are often assumed to have no quality of life (QOL) impairments after treatment because of thyroid cancer's good prognosis. Each of the items is scored and converted on a scale of 0 to 100 [26]. A conceptual model of patient outcomes. Quality of life after thyroid cancer surgery is decreased if parathyroid hormone levels are low after surgery. In the United States alone, it is estimated that over 150,000 thyroidectomies are performed annually [4]. This review supplies evidence regarding HrQoL following thyroid surgery, which can be employed in such decisions. He also pointed to several more specific concerns seen with total thyroidectomy. b FTC: follicular thyroid carcinoma. For the two studies comparing postoperative TT HrQoL with AS, significant impairments were found in the surgery group for global physical subscale (n = 1), weight gain (n = 1), problems with scar (n = 1), and vocal symptoms (n = 1) [60,67]. You would expect that the outcome in patient satisfaction, which is a function of complications, and the possible need for lifelong thyroid hormone dosing, is going to be directly proportional to whether patients have a hemithyroidectomy or total thyroidectomy, he said. Our results suggest that patients undergoing TT may suffer more impairment in physical and social HrQoL than patients undergoing HT. Total thyroidectomy: surgery to remove the entire thyroid gland. Fifth, it is well-known that RAI treatment can lead to significant and potentially long-lasting side effects, and thus be detrimental to DTC patients HrQoL [95]. Q2. Studies reporting results only in the context of thyroid-hormone withdrawal or recombinant human TSH stimulation were also excluded. Long-term recurrence of small papillary thyroid cancer and its risk factors in a korean multicenter study. Johansson B., Brandberg Y., Hellbom M., Persson C., Petersson L.M., Berglund G., Glimelius B. Health-related quality of life and distress in cancer patients: Results from a large randomised study. van Hout B., Janssen M.F., Feng Y.S., Kohlmann T., Busschbach J., Golicki D., Lloyd A., Scalone L., Kind P., Pickard A.S. Interim scoring for the EQ-5D-5L: Mapping the EQ-5D-5L to EQ-5D-3L value sets. The remaining studies were from Canada (n = 1), Austria (n = 1), Sweden (n = 1), Finland (n = 1), Italy (n = 1), Greece (n = 1), Japan (n = 1), Australia (n = 1), and Egypt (n = 1). Inclusion in an NLM database does not imply endorsement of, or agreement with, This is consistent with our findings regarding physical-related HrQoL and previous research highlighting the fact that despite the excellent prognosis of the disease, HrQoL may be impaired in patients with thyroid neoplasms compared to the general population for up to 20 years following cancer treatment [15,16,17,18,19]. Among these studies, six found a significant decrease in HrQoL for at least one of the following items: bodily pain (n = 1), vitality (n = 2), physical functioning (n = 3), speech (n = 1), general or physical fatigue (n = 1), and sleep (n = 1) [18,34,53,55,58,61]. Hedman C., Strang P., Djrv T., Widberg I., Lundgren C.I. Each item is scored on a scale of 0 to 3, with a maximum score of 21 for each component [48]. This included worse physical functioning, emotional functioning and social functioning, as well as more tingling/numbness, more restlessness, more fatigue, more difficulty breathing and more difficulty sleeping. Nonetheless, it appears clear that DTC patients frequently struggle with both physical and psychological symptoms following surgery. found that an interdisciplinary-team-based care approach including a nurse navigator improved overall well-being and improved levels of physical and practical concerns in patients treated for thyroid cancer [90]. Achievements and challenges. The Short Form of the Fear of Progression Questionnaire (FoP-Q-SF) is a 12-item version of its predecessor (FoP) [37]. 2020 Quality of life in patients with hypoparathyroidism after treatment for thyroid cancer.J Clin Endocrinol Metab. The initial search resulted in a total of 2507 records that were imported into the Covidence systematic review software Version v2625 (Veritas Health Innovation, Melbourne, Australia) for screening and eligibility assessment (Figure 1). While it has frequently been assumed that the decrease in HrQoL of patients with DTC was mostly attributed to treatment modalities and their associated complications, current evidence remains unclear on this matter. The study also found that more extensive surgery (neck dissection/lymph node removal during thyroid surgery) was more likely to result in permanently low parathyroid hormone levels. Quality of life in patients with Hashimoto thyroiditis who undergo thyroidectomy is equivalent to the general population, and the majority are satisfied with surgery. Lobectomy: surgery to remove one lobe of the thyroid. described a psychological and behavioral intervention that resulted in improvements in functional capacities, global QoL, and depression and anxiety symptoms at 1-year follow-up for DTC patients treated with surgery and RAI [89]. This study documents that patients who can get away with hemithyroidectomy when appropriately selected are going to be happier long-term than people with total thyroidectomy, said Christopher Umbricht, MD, PhD, an associate professor of oncology at Johns Hopkins Sidney Kimmel Cancer Center, in an interview with Cancer Network. Four studies found a significant decrease in psychological-related HrQoL for the following items: psychological symptoms (n = 1), emotional functioning (n = 1), state anxiety (n = 1), and mental health (n = 1) for patients undergoing TT versus HT [56,59,62,63]. Utility and validity of the STAI with anxiety disorder patients. Health-related quality-of-life assessment in surgical patients with papillary thyroid carcinoma A single-center analysis from Mainland China. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework was used to guide the search and the reporting of the review [20]. If all four of the parathyroid glands are damaged, or accidently removed, during surgery, calcium levels will be too low after surgery. van Gerwen M., Cooke P.V., Alpert N., Mols F., Genden E., Schwartz R.M. JAMA Otolaryngology-Head & Neck Surger,y 2019. Mean quality of life symptom score improved from 16.16 before surgery to 9.14 short term after surgery (P < .001) and 10.04 long term (P = .02). Two researchers independently assessed the risk of bias using the Joanna Briggs Institute (JBI) critical-appraisal checklists, which allows for the assessment of quantitative and qualitative studies [22]. It is very important for people who need thyroid cancer surgery to understand this possible surgical complication and take steps to minimize the risk that this will happen to them. Guidelines for the management of thyroid cancer. One of these studies observed no significant difference between groups, while one of them detected a significant improvement in overall HrQoL at one year postoperatively, and one of them observed improved QoL at 2 to 4 weeks postoperatively [66,68,73]. In this review, we identified 20 studies reporting on physical HrQoL following TT or HT [18,34,51,52,53,54,55,56,57,58,59,60,61,62,64,65,67,68,70,73] (Table 5). [(accessed on 26 February 2022)]. Vargas-Salas S., Martnez J.R., Urra S., Domnguez J.M., Mena N., Uslar T., Lagos M., Henrquez M., Gonzlez H.E. Salivary morbidity and quality of life following radioactive iodine for well-differentiated thyroid cancer. WHAT ARE THE IMPLICATIONS OF THIS STUDY? Surgery for papillary thyroid carcinoma: Is lobectomy enough? Diamond-Rossi S.A., Jonklaas J., Jensen R.E., Kuo C., Stearns S., Esposito G., Davidson B.J., Luta G., Bloom G., Graves K.D. Five of these studies found significant impairment in social-related HrQoL in TT patients compared with the general population for at least one of the following items: social functioning and interactions (n = 4), role limitations due to emotional or physical health (n = 5), and reduced activity (n = 1) [18,51,53,55,58,61]. Q2. The choice of surgery is also influenced by the degree of disease, he said. In thyroid disease, it has long been thought that symptoms related to thyroid dysfunction and treatment-related morbidity were the main contributing factors to postoperative impairment in HrQoL. Q9. Exposure was measured in a valid and reliable way? Items are scored on a scale from 1 to 4, with higher scores reflecting greater cancer-related concerns [38]. Herschbach P., Berg P., Dankert A., Duran G., Engst-Hastreiter U., Waadt S., Keller M., Ukat R., Henrich G. Fear of progression in chronic diseases: Psychometric properties of the fear of progression questionnaire. The research is ethical according to current criteria, and there is evidence of ethical approval by an appropriate body? Due to limited resources for the translation of studies, only articles written in English or French were included. Current evidence seems to indicate that there are no significant differences in psychological-related HrQoL for patients undergoing HT versus TT, although the latter may be associated with less fear of recurrence or cancer-related worry. Recognizing that the appropriate extent of surgery in the management of DTC remains a recurrent subject of debate, we aim to systematically review the literature comparing TT and HT with regard to postoperative HrQoL with the goal of providing peer-reviewed information to clinicians that may be integrated into the shared treatment decision-making process with their patients. Four references were identified by hand-searched expert recommendations. Extent of surgery for papillary thyroid cancer is not associated with survival: An analysis of 61,775 patients. Q6. No studies assessed the social-related HrQoL of HT patients in comparison with healthy controls. 2021;doi:10.1089/thy.2021.0285. More comprehensive, longitudinal, homogenous studies, including larger sample sizes, are needed in order to fully elucidate the impacts of TT and HT on DTC patients HrQoL. There seems to be no difference in psychological-related HrQoL for patients undergoing surgery versus active surveillance, which may suggest that the previously described impairment in psychological-related HrQoL may be strongly associated with the diagnosis of cancer rather than only the necessity for treatments or medical appointments. First, the important heterogeneity of included studies, both in terms of QoL instruments used, and postoperative times of assessment limited comparison across studies and did not allow for a meta-analysis to be performed. As a library, NLM provides access to scientific literature. However, recognizing the indolent nature and excellent survival outcomes of most thyroid malignancies, recent guidelines have trended towards de-escalation of treatment for low-risk thyroid tumors. Most clinicians now recommend total thyroidectomy, but little information is available regarding quality-of-life (QOL) outcomes for this procedure. Looking under the hood of the cadillac of cancers: Radioactive iodine-related craniofacial side effects among patients with thyroid cancer.