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Surgery. 2019 Mar 18. pii: S0039-6060(19)30066-2. doi: 10.1016/j.surg.2019.01.034. [Epub ahead of print]

Clinical factors associated with worse quality-of-life scores in United States thyroid cancer survivors.

Author information

1
Northwestern University Feinberg School of Medicine, Chicago, IL.
2
Northwestern University Feinberg School of Medicine, Department of Preventive Medicine, Chicago, IL.
3
Northwestern University Feinberg School of Medicine, Department of Medical Social Sciences, Chicago, IL.
4
Northwestern University Feinberg School of Medicine, Department of Surgery, Chicago, IL. Electronic address: cord.sturgeon@nm.org.

Abstract

INTRODUCTION:

Thyroid cancer survivors are a rapidly growing population in the United States. The factors that drive health-related quality of life (HRQOL) in this population have not been well characterized. We hypothesized that more aggressive treatments and greater treatment-related adverse effects would be associated with worse HRQOL scores in thyroid cancer survivors.

METHODS:

Thyroid cancer survivors (18-89 years of age) completed an online survey regarding their clinical history in addition to the Patient-Reported Outcomes Measurement Information System (PROMIS) 29 instrument. Univariable and multivariable modeling were performed to evaluate factors associated with worse HRQOL scores. We generated β-values and 95% confidence intervals to quantify the effect of each independent variable in the model.

RESULTS:

Thyroid cancer survivors (n = 1,743) reported a high incidence of complications related to surgery and radioactive iodine ablation. Postoperative dysphonia (ß 1.83-3.07) and dysphagia (ß 2.05-3.65) predicted worse HRQOL scores across multiple PROMIS domains. Younger patient age (age <45 years) and short- or long-term complications of radioactive iodine, including gastrointestinal symptoms (51.9%), appetite changes (71.2%), sialadenitis (58.1%), xerostomia (73.3%), and xerophthalmia (45.1%) were associated with worse HRQOL scores (P < .01).

CONCLUSION:

The factors associated with significantly worse HRQOL scores across multiple PROMIS domains for thyroid cancer survivors included patient age <45 years, postoperative hypocalcemia, dysphonia, dysphagia, scar appearance, and complications from radioactive iodine. Methods of evaluation, management, and prevention of these factors might positively impact HRQOL.

PMID:
30898373
DOI:
10.1016/j.surg.2019.01.034

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