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      Quality of life following lobectomy versus total thyroidectomy is significantly related to hypothyroidism

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          Abstract

          Objective

          The aim of the present study was to investigate the differences in quality of life (QOL) following complete or partial thyroidectomy and with regard to thyroid hormone replacement (LT4) therapy.

          Study Design

          Patients who underwent thyroidectomy were asked to complete the validated thyroid‐specific ThyPRO QOL questionnaire at least 6 months following surgery.

          Setting

          Tertiary medical center.

          Methods

          Thyroid specific QOL questionnaire analysis.

          Results

          A total of 190 patients completed the ThyPRO questionnaire. Of them 89 patients had complete thyroidectomy and 101 patients had unilateral thyroid lobectomy. The total thyroidectomy group had significantly worse overall QOL self‐assessment score than the lobectomy patients ( p < 0.0001). Patients receiving LT4 therapy regardless of the extent of surgery, reported worse QOL compared to patients not receiving LT4.

          Conclusions

          Quality of life following thyroid surgery is significantly related to hypothyroidism and the requirement for LT4 therapy, rather to the extent of surgery. The best QOL was reported in patients treated with lobectomy who did not require LT4 therapy.

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          Most cited references20

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          2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.

          Bryan Haugen, Erik Alexander, Keith Bible … (2016)
          Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer.
          Article 0 comments Cited 2754 times – based on 0 reviews     Review now
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            2013 ETA Guideline: Management of Subclinical Hypothyroidism

            Simon Pearce, Georg Brabant, Leonidas H. Duntas … (2013)
            Subclinical hypothyroidism (SCH) should be considered in two categories according to the elevation in serum thyroid-stimulating hormone (TSH) level: mildly increased TSH levels (4.0-10.0 mU/l) and more severely increased TSH value (>10 mU/l). An initially raised serum TSH, with FT4 within reference range, should be investigated with a repeat measurement of both serum TSH and FT4, along with thyroid peroxidase antibodies, preferably after a 2- to 3-month interval. Even in the absence of symptoms, replacement therapy with L-thyroxine is recommended for younger patients ( 10 mU/l. In younger SCH patients (serum TSH 80-85 years) with elevated serum TSH ≤10 mU/l should be carefully followed with a wait-and-see strategy, generally avoiding hormonal treatment. If the decision is to treat SCH, then oral L-thyroxine, administered daily, is the treatment of choice. The serum TSH should be re-checked 2 months after starting L-thyroxine therapy, and dosage adjustments made accordingly. The aim for most adults should be to reach a stable serum TSH in the lower half of the reference range (0.4-2.5 mU/l). Once patients with SCH are commenced on L-thyroxine treatment, then serum TSH should be monitored at least annually thereafter.
            Article 0 comments Cited 212 times – based on 0 reviews     Review now
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              Complications to thyroid surgery: results as reported in a database from a multicenter audit comprising 3,660 patients.

              G Wallin, H Mårtensson, I Lausen … (2008)
              During recent years, more radical surgery for thyroid disease, i.e., total instead of subtotal resection, has been evident. Results following this strategy on national levels are scarce. From 2004 to 2006, 26 Scandinavian Departments registered 3,660 thyroid operations in a database. Risk factors for complications were analyzed with multiple logistic regression. After thyroidectomy, re-bleeding occurred in 2.1% and was associated with older age (OR 1.04; p < 0.0001) and male gender (OR 1.90; p = 0.014). Postoperative infection occurred in 1.6% and associated with lymph node operation (OR 8.18; p < 0.0001). Postoperative unilateral paresis of the recurrent laryngeal nerve was diagnosed 3.9% and bilateral paresis in 0.2%. Unilateral paresis was associated with older age, intrathoracic goiter, thyreotoxicosis, and if routine laryngoscopy was practiced (OR 1.92; p = 0.0002). After 6 months, the incidence of nerve paresis was 0.97%. After bilateral thyroid surgery (n = 1,648), hypocalcaemia treated with vitamin D analogue occurred in 9.9% of the patients at the first follow-up and in 4.4% after 6 months. Complications to thyroid surgery are not uncommon. The high frequency of hypocalcaemia treated with vitamin D after 6 months is a cause of concern.
              Article 0 comments Cited 152 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Dan Yaniv:
                ORCID: http://orcid.org/0000-0002-0654-1161
                dan_yaniv6@yahoo.com
                Journal
                Journal ID (nlm-ta): J Surg Oncol
                Journal ID (iso-abbrev): J Surg Oncol
                Journal ID (doi): 10.1002/(ISSN)1096-9098
                Journal ID (publisher-id): JSO
                Title: Journal of Surgical Oncology
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Print): 0022-4790
                ISSN (Electronic): 1096-9098
                Publication date (Electronic): 11 June 2022
                Publication date (Print): 15 September 2022
                Volume: 126
                Issue: 4 ( doiID: 10.1002/jso.v126.4 )
                Pages: 640-648
                Affiliations
                [ 1 ] Department of Otorhinolaryngology—Head and Neck Surgery Rabin Medical Center Petah Tikva Israel
                [ 2 ] Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
                [ 3 ] Institute of Endocrinology, Diabetes and Metabolism Rabin Medical Center Petah Tikva Israel
                [ 4 ] Department of Endocrinology National University Hospital Copenhagen Denmark
                [ 5 ] Department of Otorhinolaryngology—Head and Neck Surgery, Rambam Healthcare Campus, Technion‐Israel Institute of Technology Rappaport Faculty of Medicine Haifa Israel
                Author notes
                [*] [* ] Correspondence Dan Yaniv, MD, Department of Otolaryngology—Head and Neck Surgery, Rabin Medical Center, 39 Jabotinski St., Petah Tikva 49100, Israel. 

                Email: dan_yaniv6@ 123456yahoo.com

                Author information
                http://orcid.org/0000-0002-0654-1161
                http://orcid.org/0000-0001-7462-1086
                Article
                Publisher ID: JSO26983
                DOI: 10.1002/jso.26983
                PMC ID: 9544480
                PubMed ID: 35689620
                SO-VID: 020aeb37-ee9d-4128-a80a-94f93ff43b56
                Copyright © © 2022 The Authors. Journal of Surgical Oncology published by Wiley Periodicals LLC.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Date revision received : 24 May 2022
                Date received : 16 February 2022
                Date accepted : 27 May 2022
                Page count
                Figures: 5, Tables: 2, Pages: 9, Words: 4190
                Categories
                Subject: Head/Neck, Thyroid, Endocrine
                Subject: Head/Neck, Thyroid, Endocrine
                Custom metadata
                source-schema-version-number 2.0
                cover-date September 15, 2022
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.0 mode:remove_FC converted:07.10.2022

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: hypothyroidism,pro,qol,thyroidectomy,tsh
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: hypothyroidism, pro, qol, thyroidectomy, tsh

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