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Submitted on May 31, 2007
Accepted on October 11, 2007
Department of Endocrinology and Metabolism, Leiden University Medical Centre, the Netherlands
* To whom correspondence should be addressed. E-mail: J.W.A.Smit{at}lumc.nl.
Objective: This study was performed to evaluate the impact of cured differentiated thyroid carcinoma (DTC) on quality of life. Previous studies on quality of life in patients with DTC were hampered by small patient numbers, limited of quality of life parameters or were uncontrolled.
Design: Cross-sectional case-control study.
Method: We assessed quality of life in 153 cured DTC patients with a median duration of cure of 6.34 years (range 0.3–41.8) and studied the contribution of disease specific, biochemical and social variables, focusing on the degree of TSH suppression. Four validated health-related questionnaires were used (Short Form-36, Multidimensional Fatigue Index-20, Hospital Anxiety and Depression Scale and Somatoform Disorder Questionnaire), including multiple aspects of physical, psychological and social functioning. Patients were compared with 113 controls selected by patients themselves (control group-I), and with 336 pooled age- and gender-matched controls from other Leiden quality of life studies (control group-II).
Results: Patients had significantly decreased quality of life in 11 of 16 subscales when compared with control group-I. Comparison with control group-II, decreased scores in 13 of 16 items were observed. An important independent predictor for quality of life was duration of cure. Quality of life parameters were not influenced by serum TSH levels, both measured at the time of quality of life assessment and measured over time since initial therapy.
Conclusions: Patients cured for DTC have impaired quality of life, independently of TSH level. Quality of life parameters were inversely affected by duration of cure and consequently may be restored after prolonged follow-up.
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