title: Long-Term Quality of Life in Adult Survivors of Pediatric Differentiated Thyroid Carcinoma.
abstract: Little is known about long-term quality of life (QoL) of survivors of pediatric differentiated thyroid carcinoma. Therefore, this study aimed to evaluate generic health-related QoL (HRQoL), fatigue, anxiety, and depression in these survivors compared with matched controls, and to evaluate thyroid cancer-specific HRQoL in survivors only.
  
  
  
  Survivors diagnosed between 1970 and 2013 at age ≤18 years, were included. Exclusion criteria were a follow-up <5 years, attained age <18 years, or diagnosis of DTC as a second malignant neoplasm (SMN). Controls were matched by age, sex, and socioeconomic status. Survivors and controls were asked to complete 3 questionnaires [Short-Form 36 (HRQoL), Multidimensional Fatigue Inventory 20 (fatigue), and Hospital Anxiety and Depression Scale (anxiety/depression)]. Survivors completed a thyroid cancer-specific HRQoL questionnaire.
  
  
  
  Sixty-seven survivors and 56 controls. Median age of survivors at evaluation was 34.2 years (range, 18.8 to 61.7). Median follow-up was 17.8 years (range, 5.0 to 44.7). On most QoL subscales, scores of survivors and controls did not differ significantly. However, survivors had more physical problems (P = 0.031), role limitations due to physical problems (P = 0.021), and mental fatigue (P = 0.016) than controls. Some thyroid cancer-specific complaints (e.g., sensory complaints and chilliness) were present in survivors. Unemployment and more extensive disease or treatment characteristics were most frequently associated with worse QoL.
  
  
  
  Overall, long-term QoL in survivors of pediatric DTC was normal. Survivors experienced mild impairment of QoL in some domains (physical problems, mental fatigue, and various thyroid cancer-specific complaints). Factors possibly affecting QoL need further exploration.
authors.affiliation: Department of Endocrinology.
authors.forename: Marloes
authors.initials: M
authors.lastname: Nies
authors.affiliation: Department of Endocrinology.
authors.forename: Mariëlle S
authors.initials: MS
authors.lastname: Klein Hesselink
authors.affiliation: Wenkebach Institute, School of Nursing and Health, Departments of.|Pediatric Oncology and.
authors.forename: Gea A
authors.initials: GA
authors.lastname: Huizinga
authors.affiliation: Wenkebach Institute, School of Nursing and Health, Departments of.
authors.forename: Esther
authors.initials: E
authors.lastname: Sulkers
authors.affiliation: Nuclear Medicine and.
authors.forename: Adrienne H
authors.initials: AH
authors.lastname: Brouwers
authors.affiliation: Molecular Imaging, Epidemiology, and.
authors.forename: Johannes G M
authors.initials: JGM
authors.lastname: Burgerhof
authors.affiliation: Department of Internal Medicine, VU University Medical Center, 1007 MB Amsterdam, The Netherlands.
authors.forename: Eveline W C M
authors.initials: EWCM
authors.lastname: van Dam
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Maastricht University Medical Center, 6202 AZ Maastricht, The Netherlands.
authors.forename: Bas
authors.initials: B
authors.lastname: Havekes
authors.affiliation: Department of Pediatric Oncology, Sophia Children's Hospital, Erasmus Medical Center, 3000 CB Rotterdam, The Netherlands.
authors.forename: Marry M
authors.initials: MM
authors.lastname: van den Heuvel-Eibrink
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, 2300 RC Leiden, The Netherlands.
authors.forename: Eleonora P M
authors.initials: EPM
authors.lastname: Corssmit
authors.affiliation: Department of Pediatric Oncology, Emma Children's Hospital, and.
authors.forename: Leontien C M
authors.initials: LCM
authors.lastname: Kremer
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands.
authors.forename: Romana T
authors.initials: RT
authors.lastname: Netea-Maier
authors.affiliation: Department of Pediatric Oncology, Emma Children's Hospital, and.|Department of Medical Oncology, Academic Medical Center, 1100 DD Amsterdam, The Netherlands.
authors.forename: Heleen J H
authors.initials: HJH
authors.lastname: van der Pal
authors.affiliation: Department of Internal Medicine and Rotterdam Thyroid Center, Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands.
authors.forename: Robin P
authors.initials: RP
authors.lastname: Peeters
authors.affiliation: Surgical Oncology.
authors.forename: John T M
authors.initials: JTM
authors.lastname: Plukker
authors.affiliation: Department of Pediatric Oncology, Emma Children's Hospital, and.
authors.forename: Cécile M
authors.initials: CM
authors.lastname: Ronckers
authors.affiliation: Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands.
authors.forename: Hanneke M
authors.initials: HM
authors.lastname: van Santen
authors.affiliation: Pediatric Oncology and.
authors.forename: Wim J E
authors.initials: WJE
authors.lastname: Tissing
authors.affiliation: Department of Endocrinology.
authors.forename: Thera P
authors.initials: TP
authors.lastname: Links
authors.affiliation: Pediatric Endocrinology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
authors.forename: Gianni
authors.initials: G
authors.lastname: Bocca
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005221:Fatigue / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D005222:Mental Fatigue / Q000523:psychology; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D017741:Survivors / Q000523:psychology*; D013964:Thyroid Neoplasms / Q000628:therapy*; D055815:Young Adult