Quality of Life in Patients with Papillary Thyroid Microcarcinoma Managed by Active Surveillance or Lobectomy: A Cross-Sectional Study

Thyroid ◽  
2019 ◽  
Vol 29 (7) ◽  
pp. 956-962 ◽  
Author(s):  
Min Ji Jeon ◽  
Yu-Mi Lee ◽  
Tae-Yon Sung ◽  
Minkyu Han ◽  
Yong-Wook Shin ◽  
...  
Author(s):  
Alex González Bóssolo ◽  
Michelle Mangual Garcia ◽  
Paula Jeffs González ◽  
Miosotis Garcia ◽  
Guillermo Villarmarzo ◽  
...  

Summary Classical papillary thyroid microcarcinoma (PTMC) is a variant of papillary thyroid carcinoma (PTC) known to have excellent prognosis. It has a mortality of 0.3%, even in the presence of distance metastasis. The latest American Thyroid Association guidelines state that although lobectomy is acceptable, active surveillance can be considered in the appropriate setting. We present the case of a 37-year-old female with a history of PTMC who underwent surgical management consisting of a total thyroidectomy. Although she has remained disease-free, her quality of life has been greatly affected by the sequelae of this procedure. This case serves as an excellent example of how first-line surgical treatment may result more harmful than the disease itself. Learning points: Papillary thyroid microcarcinoma (PTMC) has an excellent prognosis with a mortality of less than 1% even with the presence of distant metastases. Active surveillance is a reasonable management approach for appropriately selected patients. Patients should be thoroughly oriented about the risks and benefits of active surveillance vs immediate surgical treatment. This discussion should include the sequelae of surgery and potential impact on quality of life, especially in the younger population. More studies are needed for stratification of PTMC behavior to determine if conservative management is adequate for all patients with this specific disease variant.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Soo Myoung Shin ◽  
Sung Hye Kong ◽  
Junsun Ryu ◽  
Min Joo Kim ◽  
Sun Wook Cho ◽  
...  

Abstract Background: The Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) started in June 2016. As a follow-up study of comparing the quality of life (QoL) of the active surveillance (AS) and immediate surgery (OP) groups at 8 months (9.3±4.8 and 7.1±4.2 months, respectively), here we aimed to compare the QoL between the AS and OP groups after 18 months (22.8±4.0 and 22.3±4.3 months, respectively) of follow-up. Methods: QoL of 108 participants who chose AS, 101 who underwent OP, twelve who changed from AS to OP was evaluated using a thyroid-specific QoL questionnaire at diagnosis and during follow-up (median 23 months). Results: The mean ages of the participants in the AS and OP groups were 47.7±11.0 and 45.1±10.0 years (p=0.075), respectively. At baseline, better physical (8.2±1.4 vs. 7.6±1.8, p=0.032), psychological (7.4±1.2 vs. 6.7±1.6, p=0.010), and total health (7.4±1.0 vs. 6.7±1.3, p=0.005) were observed in the AS group than in the OP group. After a mean follow up of 22.7±4.2 months, better physical (8.1±1.5 vs. 7.4±1.7, p=0.008), psychological (7.7±1.3 vs. 7.0±1.5, p=0.002), and total health (7.5±1.2 vs. 6.8±1.3, p=0.001) were observed in the AS group than in the OP group, whereas spiritual health was comparable between the two groups: compared with the AS group, the OP group experienced more alterations in appetite, sleep, menstrual cycle, voice, motor skill, weight, appearance, cold or heat tolerance, and body swelling. Furthermore, better QOL scores were observed in the AS group in self-concept, personal relationships, sexual life, work motivation, productivity and quality of work, feeling of isolation, driving, doing household chores, preparing meals and doing leisure activities after long term follow up. Conclusion: Patients who underwent AS had better QOL even after long term follow up. Low risk papillary thyroid microcarcinomas do not influence survival, however surgery related deterioration of QOL lasted long and did not improve even in late post-operative stages when patients were fully recovered from surgery. Keywords: Quality of life; papillary thyroid microcarcinoma; active surveillance; immediate surgery


2019 ◽  
pp. 55-62
Author(s):  
Vuong Diem Khanh Doan ◽  
Ngoc Minh Chau Ho ◽  
Thi Van Ngo ◽  
Thi Bao Nga Phan ◽  
Thi Hong Phan Nguyen

Background: Vietnam is entering the stage of aging population; as a result, the quality of life (QOL) of the elderly is really a matter of concern. There is a great deal of research on the quality of life of the elderly while Vietnam witnesses a lack of research on this topic, especially on how physical and social activities have impact on QOL of the elderly. Objectives: (1) To describe the situation of participation in physical, social activities and QOL of the elderly residing in Truong An Ward, Hue city. (2) To examine the association between physical, social activities and QOL among participants. Methodology: This study used cross-sectional study design. A total sample of 420 people aged 60 and above in Truong An Ward, Hue city were interviewd. The SF36 was used to measure the QOL of participants. Results: Percentage of the elderly taking part in physical activity were 66%. 49% reported having the habit of taking part in social activities. The majority of the elderly get their QOL level in three health fields, namely physical, mental and general health at above average. (56.0, 60.7 and 60.8 respectively). There were significant associations between physical activities, social activities and QOL among participants. Conclusion: The percentage of the elderly taking part in physical and social activities were still low. Besides, QOL of the elderly at the research location was not really high. It’s important to encourage the elderly taking part in physical and social activities to improve their quality of life. Key words: Physical activities, social activities, QOL, the elderly


Sign in / Sign up

Export Citation Format

Share Document