Clinical predictors of quality of life in patients with initial differentiated thyroid cancers.
BACKGROUND
Patients with differentiated thyroid cancer (DTC) usually have a good prognosis. Traditionally, treatment success in patients with cancer has been evaluated by survival time. Recently, it has been observed that the diagnosis and treatment of cancer also have a strong effect on the quality of life (QOL) of these patients.


OBJECTIVE
To assess the QOL of patients with DTC and its potential clinical predictors.


METHODS
Cross-sectional analysis.


METHODS
A tertiary cancer institution.


METHODS
One hundred fifty-four patients submitted to thyroidectomy (1997-2006) were evaluated using the University of Washington Quality of Life questionnaire.


METHODS
Descriptive analysis of the results was done, as bivariate and multivariate analyses to compare each independent variable with each of 13 QOL domains.


RESULTS
Patients 45 years or younger had better recreation scores than did patients older than 45 years (P = .04). Thirty-eight patients were submitted to neck dissection. Patients submitted to modified radical neck dissection reported worse chewing and shoulder scores than did patients submitted to selective paratracheal lymph node dissection only and those without neck dissection (P = .003 and P = .004, respectively). Patients who received more than 150 mCi of radioactive iodine therapy (RIT) reported significantly worse pain, swallowing, chewing, speech, taste, anxiety, and composite scores. Comorbidities showed significant effect on recreation, activity, speech, saliva, and composite scores (P = .02, P = .046, P = .02, P = .01, and P = .008, respectively). In multivariate analysis, RIT is the only variable associated with a worse composite score (P = .003).


CONCLUSIONS
Although QOL after treatment of thyroid cancer can be considered good for most patients, those submitted to RIT at doses higher than 150 mCi are at risk for poor QOL and, therefore, may need more intensive follow-up and treatment.
Almeida
Juliana Pereira
JP
Department of Head and Neck Surgery and Otorhinolaryngology, Hospital A. C. Camargo, Rua Professor Antônio Prudente, 211, 01509-900 São Paulo, Brazil. lp_kowalski@uol.com.br
Almeida
Juliana
J
Vartanian
José Guilherme
JG
Kowalski
Luiz Paulo
LP
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety; D003430:Cross-Sectional Studies; D003680:Deglutition Disorders / Q000209:etiology; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage / Q000009:adverse effects; D008197:Lymph Node Excision; D008297:Male; D008409:Mastication / Q000502:physiology; D008875:Middle Aged; D015999:Multivariate Analysis; D037981:Neck Dissection; D010146:Pain / Q000209:etiology; D011788:Quality of Life; D012782:Shoulder / Q000503:physiopathology; D013064:Speech Disorders / Q000209:etiology; D013651:Taste Disorders / Q000209:etiology; D013964:Thyroid Neoplasms / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D013965:Thyroidectomy
D007457:Iodine Radioisotopes