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基于患者报告结局的分化型甲状腺癌幸存者生活质量影响因素:一项单中心横断面研究。

Factors influencing the quality of life in survivors of differentiated thyroid cancer based on patient-reported outcomes: a single-center cross-sectional study.

作者信息

Dong Zhizhong, Zhan Xiangxiang, Liu Wen, Rao Dewei, Yang Miao, Peng Ying, Su Yanjun, Cheng Ruochuan

机构信息

Department of Thyroid Surgery, Clinical Research Center for Thyroid Diseases of Yunnan Province, The First Affiliated Hospital of Kunming Medical University, Kunming, China.

出版信息

Front Endocrinol (Lausanne). 2025 Apr 30;16:1565633. doi: 10.3389/fendo.2025.1565633. eCollection 2025.

Abstract

PURPOSE

While the prognosis for differentiated thyroid cancer (DTC) is favorable, the health-related quality of life (QOL) of survivors is not well understood. This study aims to investigate the factors influencing the QOL of DTC survivors.

METHODS

A total of 860 DTC survivors who underwent thyroidectomy were surveyed. Participants completed the Chinese version of the Thyroid Cancer-Specific Quality of Life (THYCA-QOL) questionnaire, the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire-C30 (EORTC QLQ-C30), and additional related questions. Multivariate regression analyses identified factors affecting survivors' QOL.

RESULTS

Among the survivors, 65 patients (7.6%) reported long-term postoperative complaints, including fatigue, throat discomfort, neck/shoulder stiffness, weight gain, and insomnia, among others. The average THYCA-QOL summary score was 20.29, with the highest scores in problems with scar, psychological problems, gained weight, less interest in sex, and sympathetic problems. The average EORTC QLQ-C30 summary score was 82.59, with lower scores for emotional and cognitive on the functional scales, and higher scores for fatigue and insomnia on the symptom scales. Women, BMI ≥ 28, higher T-stage (T3 + 4), permanent hypoparathyroidism, recurrence reoperation, and more postoperative complaints were associated with poorer thyroid cancer-specific QOL, while age over 45 years was associated with better QOL. Longer postoperative follow-up (>6 months) and drinking were correlated with higher QLQ-C30 summary scores, while recurrence reoperation and postoperative complaints were associated with worse QOL.

CONCLUSIONS

The QOL of DTC survivors is influenced by multiple factors, with some patients experiencing long-term complaints. Attention to the QOL and postoperative complaints in DTC survivors is essential.

摘要

目的

虽然分化型甲状腺癌(DTC)的预后良好,但对幸存者与健康相关的生活质量(QOL)了解不足。本研究旨在调查影响DTC幸存者生活质量的因素。

方法

共对860例行甲状腺切除术的DTC幸存者进行了调查。参与者完成了中文版的甲状腺癌特异性生活质量(THYCA-QOL)问卷、欧洲癌症研究与治疗组织生活质量核心问卷-C30(EORTC QLQ-C30)以及其他相关问题。多因素回归分析确定了影响幸存者生活质量的因素。

结果

在幸存者中,65例患者(7.6%)报告了长期术后不适,包括疲劳、咽喉不适、颈部/肩部僵硬、体重增加和失眠等。THYCA-QOL总评分平均为20.29,在瘢痕问题、心理问题、体重增加、性兴趣降低和交感神经问题方面得分最高。EORTC QLQ-C30总评分平均为82.59,在功能量表上情绪和认知方面得分较低,在症状量表上疲劳和失眠方面得分较高。女性、BMI≥28、较高的T分期(T3+4)、永久性甲状旁腺功能减退、复发再手术以及更多的术后不适与较差的甲状腺癌特异性生活质量相关,而45岁以上年龄与较好的生活质量相关。术后随访时间较长(>6个月)和饮酒与较高的QLQ-C30总评分相关,而复发再手术和术后不适与较差的生活质量相关。

结论

DTC幸存者的生活质量受多种因素影响,部分患者有长期不适。关注DTC幸存者的生活质量和术后不适至关重要。

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