Impact of total thyroidectomy on quality of life at 6 months: the prospective ThyrQoL multicentre trial

in European Journal of Endocrinology

Correspondence should be addressed to C Blanchard; Email: Claire.blanchard@chu-nantes.fr

*(E Mirallié and F Borel contributed equally to this work)

(Details of the ERCUSYN Study Group is provided in the Acknowledgements section)

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Objective

This study is to determine the impact of complications after total thyroidectomy on health-related quality of life (HR-QoL) and to identify significant predictive factors of HR-QoL changes. HR-QoL is usually impaired in patients with thyroid diseases compared to the general population. Thyroidectomy is largely performed in the case of benign thyroid benign and can be associated with long-term complications (vocal cord palsy, hypoparathyroidism).

Design

The prospective ThyrQoL multicenter trial (NCT02167529) included 800 patients who underwent total thyroidectomy for benign or malignant non-extensive disease in seven French referral hospitals between 2014 and 2016.

Methods

HR-QoL was assessed using the MOS 36-item short form health survey (SF-36) self-questionnaire with a 6-month follow-up.

Results

We observed a significant improvement of HR-QoL 6 months after surgery (P < 0.0001). Postoperative complications were associated with a non-significant impairment of HR-QoL. In multivariable analysis, Graves’ disease was associated with a significant improvement of HR-QoL (OR = 2.39 [1.49; 3.84]) and thyroid malignant disease with an impairment of HR-QoL (OR = 1.44 [0.99; 2.08]) after thyroidectomy.

Conclusion

We observed a significant improvement of HR-QoL 6 months after total thyroid surgery for benign thyroid disease.

 

     European Society of Endocrinology

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  • 1

    BianchiGPZaccheroniVSolaroliEVesciniFCeruttiRZoliMMarchesiniG. Health-related quality of life in patients with thyroid disorders. Quality of Life Research 2004 4554. (https://doi.org/10.1023/B:QURE.0000015315.35184.66)

    • Search Google Scholar
    • Export Citation
  • 2

    McMillanCBradleyCRazviSWeaverJ. Evaluation of new measures of the impact of hypothyroidism on quality of life and symptoms: the ThyDQoL and ThySRQ. Value in Health 2008 285294. (https://doi.org/10.1111/j.1524-4733.2007.00232.x)

    • Search Google Scholar
    • Export Citation
  • 3

    Abdul-SaterLHenryMMajdanAMijovicTFranklinJHBrandtMGBlackMJHierMPPayneRJ. What are thyroidectomy patients really concerned about? Otolaryngology: Head and Neck Surgery 2011 685690. (https://doi.org/10.1177/0194599811399556)

    • Search Google Scholar
    • Export Citation
  • 4

    DuclosAPeixJLColinCKraimpsJLMenegauxFPattouFSebagFTouzetSBourdySVoirinN Influence of experience on performance of individual surgeons in thyroid surgery: prospective cross sectional multicentre study. BMJ 2012 d8041. (https://doi.org/10.1136/bmj.d8041)

    • Search Google Scholar
    • Export Citation
  • 5

    EdafeOAntakiaRLaskarNUttleyLBalasubramanianSP. Systematic review and meta-analysis of predictors of post-thyroidectomy hypocalcaemia. British Journal of Surgery 2014 307320. (https://doi.org/10.1002/bjs.9384)

    • Search Google Scholar
    • Export Citation
  • 6

    BlanchardCPattouFBrunaudLHamyADahanMMathonnetMVolteauCCaillardCDurand-ZaleskiIMiralliéE Randomized clinical trial of ultrasonic scissors versus conventional haemostasis to compare complications and economics after total thyroidectomy (FOThyr). BJS Open 2017 210. (https://doi.org/10.1002/bjs5.2)

    • Search Google Scholar
    • Export Citation
  • 7

    StollSJPittSCLiuJSchaeferSSippelRSChenH. Thyroid hormone replacement after thyroid lobectomy. Surgery 2009 554558; discussion 558560. (https://doi.org/10.1016/j.surg.2009.06.026)

    • Search Google Scholar
    • Export Citation
  • 8

    LombardiCPRaffaelliMDe CreaCD’AlatriLMaccoraDMarcheseMRPaludettiGBellantoneR. Long-term outcome of functional post-thyroidectomy voice and swallowing symptoms. Surgery 2009 11741181. (https://doi.org/10.1016/j.surg.2009.09.010)

    • Search Google Scholar
    • Export Citation
  • 9

    BorelFChristouNMarretOMathonnetMCaillardCBannaniSDruiDEspitalierFBlanchardCMiralliéE. Long-term voice quality outcomes after total thyroidectomy: a prospective multicenter study. Surgery 2018 796800. (https://doi.org/10.1016/j.surg.2017.09.023)

    • Search Google Scholar
    • Export Citation
  • 10

    SpectorBCNettervilleJLBillanteCClaryJReinischLSmithTL. Quality-of-life assessment in patients with unilateral vocal cord paralysis. Otolaryngology: Head and Neck Surgery 2001 176182. (https://doi.org/10.1067/mhn.2001.117714)

    • Search Google Scholar
    • Export Citation
  • 11

    BüttnerMMusholtTJSingerS. Quality of life in patients with hypoparathyroidism receiving standard treatment: a systematic review. Endocrine 2017 1420. (https://doi.org/10.1007/s12020-017-1377-3)

    • Search Google Scholar
    • Export Citation
  • 12

    Contopoulos-IoannidisDGKarvouniAKouriIIoannidisJP. Reporting and interpretation of SF-36 outcomes in randomised trials: systematic review. BMJ 2009 a3006. (https://doi.org/10.1136/bmj.a3006)

    • Search Google Scholar
    • Export Citation
  • 13

    HuangJKMaLSongWHLuBYHuangYBDongHM. Quality of life and cosmetic result of single-port access endoscopic thyroidectomy via axillary approach in patients with papillary thyroid carcinoma. OncoTargets and Therapy 2016 40534059. (https://doi.org/10.2147/OTT.S99980)

    • Search Google Scholar
    • Export Citation
  • 14

    YueWWWangSRLiXLXuHXLuFSunLPGuoLHHeYPWangDYinZQ. Quality of life and cost-effectiveness of radiofrequency ablation versus open surgery for benign thyroid nodules: a retrospective cohort study. Scientific Reports 2016 37838. (https://doi.org/10.1038/srep37838)

    • Search Google Scholar
    • Export Citation
  • 15

    PrombergerRHermannMPallikunnelSJSeemannRMeuselMOttJ. Quality of life after thyroid surgery in women with benign euthyroid goiter: influencing factors including Hashimoto’s thyroiditis. American Journal of Surgery 2014 974979. (https://doi.org/10.1016/j.amjsurg.2013.05.005)

    • Search Google Scholar
    • Export Citation
  • 16

    PernegerTVLeplègeAEtterJFRougemontA. Validation of a French-language version of the MOS 36-Item Short Form Health Survey (SF-36) in young healthy adults. Journal of Clinical Epidemiology 1995 10511060. (https://doi.org/10.1016/0895-4356(94)00227-h)

    • Search Google Scholar
    • Export Citation
  • 17

    WareJESherbourneCD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care 1992 473483. (https://doi.org/10.1097/00005650-199206000-00002)

    • Search Google Scholar
    • Export Citation
  • 18

    DevilliersHAmouraZBesancenotJFBonnotteBPasqualiJLWahlDMaurierFKaminskyPPennaforteJLMagy-BertrandN Responsiveness of the 36-item Short Form Health Survey and the Lupus Quality of Life questionnaire in SLE. Rheumatology 2015 940949. (https://doi.org/10.1093/rheumatology/keu410)

    • Search Google Scholar
    • Export Citation
  • 19

    WoisardVBodinSPuechM. The voice handicap index: impact of the translation in French on the validation. Revue de Laryngologie Otologie Rhinologie 2004 307312.

    • Search Google Scholar
    • Export Citation
  • 20

    PernegerTLeplègeAEcosseE. Le questionnaire MOS SF-36: manuel de l’utilisateur et guide d’interprétation des scores. Paris: Editions Estem2001.

    • Search Google Scholar
    • Export Citation
  • 21

    MiccoliPMinutoMNPagginiRRucciPOppoADonatiniGGoliaFNovelliLCarliniMDell’OssoL. The impact of thyroidectomy on psychiatric symptoms and quality of life. Journal of Endocrinological Investigation 2007 853859. (https://doi.org/10.1007/BF03349227)

    • Search Google Scholar
    • Export Citation
  • 22

    MishraASabaretnamMChandGAgarwalGAgarwalAVermaAKMishraSK. Quality of life (QoL) in patients with benign thyroid goiters (pre- and post-thyroidectomy): a prospective study. World Journal of Surgery 2013 23222329. (https://doi.org/10.1007/s00268-013-2133-3)

    • Search Google Scholar
    • Export Citation
  • 23

    BukvicBRZivaljevicVRSipeticSBDiklicADTausanovicKMPaunovicIR. Improvement of quality of life in patients with benign goiter after surgical treatment. Langenbeck’s Archives of Surgery 2014 755764. (https://doi.org/10.1007/s00423-014-1221-7)

    • Search Google Scholar
    • Export Citation
  • 24

    ZivaljevicVRBukvic BacoticBRSipeticSBStanisavljevicDMMaksimovicJMDiklicADPaunovicIR. Quality of life improvement in patients with Hashimoto thyroiditis and other goiters after surgery: a prospective cohort study. International Journal of Surgery 2015 150155. (https://doi.org/10.1016/j.ijsu.2015.08.001)

    • Search Google Scholar
    • Export Citation
  • 25

    LeeMCParkHLeeBCLeeGHChoiIJ. Comparison of quality of life between open and endoscopic thyroidectomy for papillary thyroid cancer. Head and Neck 2016 E827E831. (https://doi.org/10.1002/hed.24108)

    • Search Google Scholar
    • Export Citation
  • 26

    CramonPBonnemaSJBjornerJBEkholmOFeldt-RasmussenUFrendlDMGroenvoldMHegedüsLRasmussenÅKWattT. Quality of life in patients with benign nontoxic goiter: impact of disease and treatment response, and comparison with the general population. Thyroid 2015 284291. (https://doi.org/10.1089/thy.2014.0433)

    • Search Google Scholar
    • Export Citation
  • 27

    CramonPWintherKHWattTBonnemaSJBjornerJBEkholmOGroenvoldMHegedüsLFeldt-RasmussenURasmussenÅK. Quality-of-life impairments persist six months after treatment of Graves’ hyperthyroidism and toxic nodular goiter: a prospective cohort study. Thyroid 2016 10101018. (https://doi.org/10.1089/thy.2016.0044)

    • Search Google Scholar
    • Export Citation
  • 28

    SorensenJRWattTCramonPDøssingHHegedüsLBonnemaSJGodballeC. Quality of life after thyroidectomy in patients with nontoxic nodular goiter: a prospective cohort study. Head and Neck 2017 22322240. (https://doi.org/10.1002/hed.24886)

    • Search Google Scholar
    • Export Citation
  • 29

    MetalloMGrozaLBrunaudLKleinMWeryhaGFeigerlovaE. Long-term quality of life and pregnancy outcomes of differentiated thyroid cancer survivors treated by total thyroidectomy and I(131) during adolescence and young adulthood. International Journal of Endocrinology 2016 7586482. (https://doi.org/10.1155/2016/7586482)

    • Search Google Scholar
    • Export Citation
  • 30

    KusLHHopmanWMWitterickIJFreemanJL. Quality-of-life outcomes in Graves disease patients after total thyroidectomy. Ear Nose and Throat Journal 2017 E8E15. (https://doi.org/10.1177/0145561317096004-501)

    • Search Google Scholar
    • Export Citation
  • 31

    HoftijzerHCHeemstraKACorssmitEPvan der KlaauwAARomijnJASmitJW. Quality of life in cured patients with differentiated thyroid carcinoma. Journal of Clinical Endocrinology and Metabolism 2008 200203. (https://doi.org/10.1210/jc.2007-1203)

    • Search Google Scholar
    • Export Citation
  • 32

    ScerrinoGMorfinoGPaladinoNCDi PaolaVAmodioEGulottaGBonventreS. Does thyroid surgery for Graves’ disease improve health-related quality of life? Surgery Today 2013 13981405. (https://doi.org/10.1007/s00595-012-0442-z)

    • Search Google Scholar
    • Export Citation
  • 33

    Abraham-NordlingMWallinGLundellGTörringO. Thyroid hormone state and quality of life at long-term follow-up after randomized treatment of Graves’ disease. European Journal of Endocrinology 2007 173179. (https://doi.org/10.1530/eje.1.02336)

    • Search Google Scholar
    • Export Citation
  • 34

    ShermanSI. Thyroid carcinoma. Lancet 2003 501511. (https://doi.org/10.1016/S0140-6736(03)12488-9)

  • 35

    MiyauchiA. Clinical trials of active surveillance of papillary microcarcinoma of the thyroid. World Journal of Surgery 2016 516522. (https://doi.org/10.1007/s00268-015-3392-y)

    • Search Google Scholar
    • Export Citation
  • 36

    SingerSLinckeTGamperEBhaskaranKSchreiberSHinzASchulteT. Quality of life in patients with thyroid cancer compared with the general population. Thyroid 2012 117124. (https://doi.org/10.1089/thy.2011.0139)

    • Search Google Scholar
    • Export Citation
  • 37

    MassoltETvan der WindtMKorevaarTIKamBLBurgerJWFranssenGJLehmphulIKöhrleJVisserWEPeetersRP. Thyroid hormone and its metabolites in relation to quality of life in patients treated for differentiated thyroid cancer. Clinical Endocrinology 2016 781788. (https://doi.org/10.1111/cen.13101)

    • Search Google Scholar
    • Export Citation
  • 38

    HussonOHaakHRBuffartLMNieuwlaatWAOranjeWAMolsFKuijpensJLCoeberghJWvan de Poll-FranseLV. Health-related quality of life and disease specific symptoms in long-term thyroid cancer survivors: a study from the population-based PROFILES registry. Acta Oncologica 2013 249258. (https://doi.org/10.3109/0284186X.2012.741326)

    • Search Google Scholar
    • Export Citation
  • 39

    GamperEMWintnerLMRodriguesMBuxbaumSNilicaBSingerSGiesingerJMHolznerBVirgoliniI. Persistent quality of life impairments in differentiated thyroid cancer patients: results from a monitoring programme. European Journal of Nuclear Medicine and Molecular Imaging 2015 11791188. (https://doi.org/10.1007/s00259-015-3022-9)

    • Search Google Scholar
    • Export Citation
  • 40

    NexoMAWattTBonnemaSJHegedüsLRasmussenÅKFeldt-RasmussenUBjornerJB. Thyroid-specific questions on work ability showed known-groups validity among Danes with thyroid diseases. Quality of Life Research 2015 16151627. (https://doi.org/10.1007/s11136-014-0896-0)

    • Search Google Scholar
    • Export Citation
  • 41

    CusanoNERubinMRMcMahonDJIraniDTulleyASlineyJJrBilezikianJP. The effect of PTH(1–84) on quality of life in hypoparathyroidism. Journal of Clinical Endocrinology and Metabolism 2013 23562361. (https://doi.org/10.1210/jc.2013-1239)

    • Search Google Scholar
    • Export Citation
  • 42

    SikjaerTMoserERolighedLUnderbjergLBislevLSMosekildeLRejnmarkL. Concurrent hypoparathyroidism is associated with impaired physical function and quality of life in hypothyroidism. Journal of Bone and Mineral Research 2016 14401448. (https://doi.org/10.1002/jbmr.2812)

    • Search Google Scholar
    • Export Citation
  • 43

    AstorMCLøvåsKDebowskaAEriksenEFEvangJAFossumCFougnerKJHolteSELimaKMoeRB Epidemiology and health-related quality of life in hypoparathyroidism in Norway. Journal of Clinical Endocrinology and Metabolism 2016 30453053. (https://doi.org/10.1210/jc.2016-1477)

    • Search Google Scholar
    • Export Citation
  • 44

    BagóAGDimitrovESaundersRSeressLPalkovitsMUsdinTBDobolyiA. Parathyroid hormone 2 receptor and its endogenous ligand tuberoinfundibular peptide of 39 residues are concentrated in endocrine, viscerosensory and auditory brain regions in macaque and human. Neuroscience 2009 128147. (https://doi.org/10.1016/j.neuroscience.2009.04.054)

    • Search Google Scholar
    • Export Citation
  • 45

    SikjaerTRolighedLHessAFuglsang-FrederiksenAMosekildeLRejnmarkL. Effects of PTH(1-84) therapy on muscle function and quality of life in hypoparathyroidism: results from a randomized controlled trial. Osteoporosis International 2014 17171726.

    • Search Google Scholar
    • Export Citation
  • 46

    StojadinovicAShahaAROrlikoffRFNissanAKornakMFSinghBBoyleJOShahJPBrennanMFKrausDH. Prospective functional voice assessment in patients undergoing thyroid surgery. Annals of Surgery 2002 823832. (https://doi.org/10.1097/00000658-200212000-00015)

    • Search Google Scholar
    • Export Citation
  • 47

    StojadinovicAHenryLRHowardRSGurevich-UvenaJMakashayMJCoppitGLShriverCDSolomonNP. Prospective trial of voice outcomes after thyroidectomy: evaluation of patient-reported and clinician-determined voice assessments in identifying postthyroidectomy dysphonia. Surgery 2008 732742. (https://doi.org/10.1016/j.surg.2007.12.004)

    • Search Google Scholar
    • Export Citation
  • 48

    VicenteDASolomonNPAvitalIHenryLRHowardRSHelouLBCoppitGLShriverCDBuckenmaierCCLibuttiSK Voice outcomes after total thyroidectomy, partial thyroidectomy, or non-neck surgery using a prospective multifactorial assessment. Journal of the American College of Surgeons 2014 152163. (https://doi.org/10.1016/j.jamcollsurg.2014.03.019)

    • Search Google Scholar
    • Export Citation
  • 49

    MaertensKde JongFI. The voice handicap index as a tool for assessment of the biopsychosocial impact of voice problems. B-ENT 2007 6166.

    • Search Google Scholar
    • Export Citation
  • 50

    VolpatoSGuralnikJMFriedLPRemaleyATCappolaARLaunerLJ. Serum thyroxine level and cognitive decline in euthyroid older women. Neurology 2002 10551061. (https://doi.org/10.1212/wnl.58.7.1055)

    • Search Google Scholar
    • Export Citation
  • 51

    WilliamsMDHarrisRDayanCMEvansJGallacherJBen-ShlomoY. Thyroid function and the natural history of depression: findings from the Caerphilly Prospective Study (CaPS) and a meta-analysis. Clinical Endocrinology 2009 484492. (https://doi.org/10.1111/j.1365-2265.2008.03352.x)

    • Search Google Scholar
    • Export Citation
  • 52

    GusseklooJvan ExelEde CraenAJMeindersAEFrölichMWestendorpRG. Thyroid status, disability and cognitive function, and survival in old age. JAMA 2004 25912599. (https://doi.org/10.1001/jama.292.21.2591)

    • Search Google Scholar
    • Export Citation
  • 53

    BoothTDearyIJStarrJM. Thyroid stimulating hormone, free thyroxine and cognitive ability in old age: the Lothian Birth Cohort Study 1936. Psychoneuroendocrinology 2013 597601. (https://doi.org/10.1016/j.psyneuen.2012.07.018)

    • Search Google Scholar
    • Export Citation
  • 54

    OjomoKASchneiderDFReiherAELaiNSchaeferSChenHSippelRS. Using body mass index to predict optimal thyroid dosing after thyroidectomy. Journal of the American College of Surgeons 2013 454460. (https://doi.org/10.1016/j.jamcollsurg.2012.12.002)

    • Search Google Scholar
    • Export Citation
  • 55

    JinJAllemangMTMcHenryCR. Levothyroxine replacement dosage determination after thyroidectomy. American Journal of Surgery 2013 360363; discussion 363364. (https://doi.org/10.1016/j.amjsurg.2012.10.015)

    • Search Google Scholar
    • Export Citation
  • 56

    WattTCramonPHegedüsLBjornerJBBonnemaSJRasmussenÅKFeldt-RasmussenUGroenvoldM. The thyroid-related quality of life measure ThyPRO has good responsiveness and ability to detect relevant treatment effects. Journal of Clinical Endocrinology and Metabolism 2014 37083717. (https://doi.org/10.1210/jc.2014-1322)

    • Search Google Scholar
    • Export Citation