Quality of life is not affected by thyroid surgery in nontoxic benign goitre in long‐term surveillance—A prospective observational study

• Published in: Endocrinology, diabetes & metabolism Vol. 3; no. 2; pp. e00115 - n/a
• Main Authors: Tabriz, Navid, Uslar, Verena N., Tabriz, Inga, Weyhe, Dirk
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01-04-2020; John Wiley and Sons Inc; Wiley
• Subjects: EQ‐5D; Females; health‐related quality of life; hemithyroidectomy; Males; Observational studies; Original; Patients; patient‐reported outcome; PRO; QoL; Quality of life; Questionnaires; Surgery; Surgical outcomes; Thyroid cancer; Thyroid diseases; total thyroidectomy; Germany; patient‐reported outcome; health‐related quality of life; EQ‐5D; hemithyroidectomy; total thyroidectomy; PRO; QoL
• DOI: 10.1002/edm2.115
• EISSN: 2398-9238

Objective
Quality of life (QoL) has so far seldom been taken into account by default in decision‐making for surgical indication in thyroid surgery. Therefore, we compared pre‐ and postoperative QoL of patients using the EuroQoL‐5D (EQ‐5D) questionnaire. The influence of certain socio‐economic factors on QoL as a second end‐point was considered.
Design
Prospective cohort study.
Patients
About 153 patients with euthyroid symptomatic benign goitre after hemi‐ and total thyroidectomy (follow‐up 83.6%) have been included.
Measurements
The EQ‐5D questionnaire was used prior to and 1 year after surgery. In addition, a questionnaire for assessment of socio‐economic status was collected.
Results
For n = 90 (n = 67 female, n = 23 male), total thyroidectomy (TT) and, for n = 63 (n = 45 female, n = 18 male), hemithyroidectomy (HT) were performed. None permanent dysfunction of the vocal cord was recorded. Transient symptomatic hypocalcaemia was detected in 9% of the thyroidectomy group (8/90 patients). At follow‐up, 86% of patients showed either no change or improved QoL. About 14% of patients complained of deteriorated QoL, regardless of the extent of surgery. Socio‐economic factors did not influence postoperative QoL.
Conclusions
Results indicate that in pre‐operative consultation of patients with benign goitre, the improvement of QoL should be taken into account for decision‐making in cases of ambiguous surgical indication. Contrary to current discussions that too much thyroid surgery is performed in Germany, we can recommend presenting surgery as an equivalent option to watchful waiting as QoL is at least preserved or improved. The extension of the resection should, however, be decided individually.
We compared pre‐ and postoperative quality of life (QoL) of patients using the EuroQoL‐5D questionnaire and the influence of certain socio‐economic factors on QoL. Results indicate that in preoperative consultation of patients with benign goiter, the improvement of QoL should be taken into account for decision‐making in cases of ambiguous surgical indication. We can recommend presenting surgery as an equivalent option to watchful waiting as QoL is at least preserved or improved.