Li Genpeng, Li Ruicen, Zhong Jinjing, Chen Wenjie, Shuai Jinhao, Chen Meizhu, Deng Feng, Wei Tao, Tang Huairong, Li Zhihui, Lei Jianyong
Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China.
The Laboratory of Thyroid and Parathyroid Disease, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China.
Nat Commun. 2025 Mar 8;16(1):2317. doi: 10.1038/s41467-025-57627-7.
The level of thyroidectomy-related regret in patients with clinically low-risk papillary thyroid microcarcinoma (PTMC) and the determinants of decision regret are largely unknown. Here, we show that 319 (24.2%) of those who undergo thyroidectomy and 4 (3.4%) who undergo active surveillance (AS) express heightened regret based on validated decision regret scale (DRS) scores in the first online survey (P < 0.001). Multivariable analysis and the second online survey for patients with heightened regret confirm that postoperative lower thyroid cancer-specific quality of life (QoL) (scar and psychology) (75.5%) is the most common factor for heightened regret of thyroidectomy, followed by preoperative understanding of disease [not at all] (15.0%), presentation of complications (3.8%) and other factors (5.7%). These results highlight that more caution should be exercised when low-risk PTMC patients are scheduled for thyroidectomy. Information about the various treatments for clinically low-risk PTMC, the risk of thyroidectomy and postoperative QoL should be fully communicated during initial counseling.
临床低风险甲状腺微小乳头状癌（PTMC）患者中甲状腺切除术相关的遗憾程度以及决策遗憾的决定因素在很大程度上尚不清楚。在此，我们发现，在首次在线调查中，接受甲状腺切除术的患者中有319例（24.2%）以及接受主动监测（AS）的患者中有4例（3.4%）根据经过验证的决策遗憾量表（DRS）评分表示出较高的遗憾程度（P < 0.001）。对遗憾程度较高的患者进行的多变量分析和第二次在线调查证实，术后较低的甲状腺癌特异性生活质量（QoL）（疤痕和心理方面）（75.5%）是甲状腺切除术遗憾程度较高的最常见因素，其次是术前对疾病的了解程度[完全不了解]（15.0%）、并发症的出现（3.8%）以及其他因素（5.7%）。这些结果表明，在为低风险PTMC患者安排甲状腺切除术时应更加谨慎。在初始咨询期间，应充分传达有关临床低风险PTMC的各种治疗方法、甲状腺切除术的风险以及术后QoL的信息。
