Abstract
Purpose Previous studies demonstrated decreased quality of life (QoL) in differentiated thyroid cancer (DTC) survivors and suggested QoL variability related to time from thyroidectomy and levothyroxine dosage. The aims of this study were to evaluate QoL in thyroidectomized subjects in different levothyroxine states and to evaluate the association between TSH and thyroid hormones and QoL. Methods Prospective 5-year study enrolling 208 patients thyroidectomized for DTC, studied in one to four times according to levothyroxine dosage: withdrawal (WITHD), complete (C-SUPP) and mild TSH-suppression (M-SUPP), replacement (REPL). Each patient was allowed to participate into the study more than one time. A total of 300 evaluations were collected, consisting of detailed thyroid hormone profile and QoL assessment through the ThyPRO questionnaire. Results Comparing the four groups, significant differences were found for anxiety, impaired social and daily life and item 12 (overall impact of thyroid disease) domains (p < 0.05). Interestingly, C-SUPP subjects reported the best scores in almost all ThyPRO scales. Significant correlations were found between QoL and pituitary-thyroid axis function, as well as between QoL and gender, being females more affected. At multiple regression analyses fT3 demonstrated to be the best explanatory factor for overall impact of thyroid disease on the patient's life, followed by gender. Conclusions TSH-suppressive doses of levothyroxine are more effective in improving QoL in DTC patients after thyroidectomy. These results confirm the urgent need of further studies aimed to define the best treatment of hypothyroidism, effective on well-being and harmless for patients.
Original language | English |
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Pages (from-to) | 319-326 |
Number of pages | 8 |
Journal | Journal of Endocrinological Investigation |
Volume | 46 |
Issue number | 2 |
Early online date | 21 Aug 2022 |
DOIs | |
Publication status | Published - Feb 2023 |
Bibliographical note
Funding Information:The study was supported by IBSA Institut Biochimique SA, without involvement in study design, collection, analysis, and interpretation of data, writing of the report, nor any restrictions regarding the submission of the report for publication. Giulia Brigante is supported by a grant of the Italian Ministry of University under the “Departments of Excellence” program.
Funding Information:
The authors are grateful to Torquill Watt from the Department of Endocrinology, Copenhagen University Hospital Rigshospitalet (Copenhagen, Denmark) for providing the validated Italian version of ThyPRO questionnaires.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Italian Society of Endocrinology (SIE).