A Long-Term Study Comparing the Quality of Life and Psychological Status of Patients with Highly Suspicious Thyroid Nodules ≤1 cm Undergoing Active Surveillance with Those Undergoing Immediate Surgery
Authors' conclusion
Patients with highly suspicious subcentimeter thyroid nodules who choose IS tend to experience a poorer long-term QoL compared to those who choose AS.
Study context
- Population
- Patients with highly suspicious subcentimeter thyroid nodules (≤1 cm)Propensity-score matching (PSM) 3:1
- Participants
- 752 patients
- Exposure
- Active surveillance vs immediate surgery
- Active surveillance (AS)n = 584
- Immediate surgery (IS)n = 168reference
- Outcome
- QoL and psychological status (THYCA-QoL, Hospital Anxiety and Depression Scale (HADS), EORTC QLQ-C30)
Methodological detailspropensity-score matched (3:1), mixed linear model
- Propensity-score matched (3:1)
- Mixed linear model
Main finding
As reported in the abstract
THYCA-QoL domains · median follow-up 24.0 (AS) and 14.2 (IS) months
- AS showed superior quality of life (QoL) outcomes compared to IS
- AS vs IS: P < 0.001 (voice)
- AS vs IS: P = 0.008 (sympathetic)
- AS vs IS: P < 0.001 (throat/mouth)
- AS vs IS: P < 0.001 (problems with scar)
- Propensity-score matched
Observational data: associations, not effects.
Further findings
European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 domains, AS vs IS
- Physical function, better with AS
- P = 0.029
- Role function, better with AS
- P < 0.001
- Social function, better with AS
- P < 0.001
- Global health status, better with AS
- P < 0.001
- Fatigue, better with AS
- P = 0.012
- Pain, better with AS
- P = 0.028
- Appetite loss, better with AS
- P = 0.017
- Financial difficulties, better with AS
- P < 0.001
Change in QoL within IS vs initial assessment (1 week after surgery)
- Voice improved
- P = 0.024
- Throat/mouth improved
- P < 0.001
- Physical function improved
- P = 0.004
- Social function improved
- P = 0.014
- Nausea and vomiting improved
- P < 0.001
- Pain improved
- P = 0.006
- Appetite loss improved
- P = 0.048
Original publication
A Long-Term Study Comparing the Quality of Life and Psychological Status of Patients with Highly Suspicious Thyroid Nodules ≤1 cm Undergoing Active Surveillance with Those Undergoing Immediate Surgery. Thyroid. Published 1 March 2024. doi:10.
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