Endocrinol Metab.  2020 Mar;35(1):115-121. 10.3803/EnM.2020.35.1.115.

Quality of Life in Patients with Papillary Thyroid Microcarcinoma According to Treatment: Total Thyroidectomy with or without Radioactive Iodine Ablation

• Ahn J
• Jeon MJ
• Song E
• Kim TY
• Kim WB
• Shong YK
• Kim WG

• KMID: 2471727
• DOI: http://doi.org/10.3803/EnM.2020.35.1.115

Abstract

BACKGROUND
Recently, there has been some controversy regarding the role of radioactive iodine (RAI) ablation in the treatment of low-risk differentiated thyroid carcinoma (DTC), especially papillary thyroid microcarcinoma (PTMC). This study aimed to compare quality of life (QoL) parameters between patients with PTMC who underwent total thyroidectomy (TT) alone and those who underwent TT with RAI ablation.
METHODS
In this cross-sectional study, patients with PTMC who underwent TT with/without RAI remnant ablation were prospectively enrolled between June 2016 and October 2017. All patients completed three questionnaires: the 12-item short-form health survey (SF-12), thyroid cancer-specific quality of life (THYCA-QoL) questionnaire, and fear of progression (FoP) questionnaire.
RESULTS
The TT and TT with RAI groups comprised 107 and 182 patients, respectively. The TT with RAI group had significantly lower serum thyrotropin (TSH) levels than the TT group. However, after matching for TSH levels between the groups (n=100 in both groups), there were no significant differences in baseline characteristics. According to the SF-12, the score for general health was significantly lower in the TT with RAI group than in the TT group (P=0.047). The THYCA-QoL also showed a significant difference in the "felt chilly" score between groups (P=0.023). No significant differences in FoP scores were observed between the groups.
CONCLUSION
Patients with PTMC who underwent TT with RAI ablation experienced more health-related problems than those managed with TT alone. These findings support the idea that RAI ablation should be carefully considered in patients with low-risk DTCs.

Keyword

Quality of life; Radioactive iodine; Thyroidectomy; Papillary thyroid microcarcinoma

MeSH Terms

Cross-Sectional Studies
Health Surveys
Humans
Iodine*
Prospective Studies
Quality of Life*
Thyroid Gland*
Thyroid Neoplasms
Thyroidectomy*
Thyrotropin
Iodine
Thyrotropin

Figure

• 

  Fig. 1 Papillary thyroid microcarcinoma (PTMC) patients were grouped by treatment type and matched by thyrotropin (TSH) levels for comparisons between groups. TT, total thyroidectomy; RAI, radioactive iodine remnant ablation.

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