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Patient-Reported Outcomes in Patients with Low-Risk Papillary Thyroid Carcinoma: Cross-Sectional Study to Compare Active Surveillance and Immediate Surgery

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Abstract

Background

This cross-sectional study compared patient-reported outcomes of low-risk papillary thyroid carcinoma (PTC, T1N0M0) between patients who underwent active surveillance (AS) and those who received immediate surgery,

Methods

Using the State-Trait Anxiety Inventory, Short-Form 36 version 2, and a visual analog scale for neck symptoms, 249 patients under AS and 32 patients underwent immediate surgery were compared. To match the difference in time from the onset of treatment to the survey, we conducted propensity score matching. We also investigated factors affecting anxiety in patients under AS in multiple linear regression analysis.

Results

In the entire group, patients under AS had significantly longer time from the onset to the survey than patients underwent immediate surgery (7.9 vs. 4.0 years). After matching, AS group showed significantly better trait anxiety and mental component summary (MCS) compared to surgery group, while surgery group showed better role-social component summary. AS group also had significantly better MCS than the Japanese norm-based score. Surgery group displayed worse neck symptoms than AS group. Among AS group, trait anxiety and time from the onset were significant predictors of state anxiety. Compared with the group with < 5 years since starting AS, the group with ≥ 5 years of follow-up showed a significantly better state anxiety only in patients with better trait anxiety.

Conclusions

Low-risk PTC patients under AS showed better trait anxiety and mental health than surgery group. After a certain period, the anxiety of patients under AS seems to be improved, especially in patients with better trait anxiety.

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Acknowledgements

We wish to acknowledge and thank Dr. Toshiaki Otsuka, Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan, for assistance with statistical analysis.

Funding

This work was partially supported by JSPS KAKENHI Grant Number 20K08995.

Author information

Authors and Affiliations

  1. Department of Endocrine Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan

    Hiroko Kazusaka, Iwao Sugitani, Masaomi Sen, Marie Saito & Ryuta Nagaoka

  2. Division of Head and Neck, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Iwao Sugitani & Kazuhisa Toda

  3. Department of Endocrine Surgery, Tokyo Women’s Medical University, 8-1, Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Yusaku Yoshida

Authors
  1. Hiroko Kazusaka
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  2. Iwao Sugitani
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  3. Kazuhisa Toda
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  4. Masaomi Sen
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  5. Marie Saito
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  6. Ryuta Nagaoka
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  7. Yusaku Yoshida
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Contributions

HK, IS, and YY contributed to study concept, design, statistical data analysis, interpretation and writing; HK, IS, KT, MS, MS, and RN carried out acquisition of the data; IS and YY performed supervision and project administration; and IS performed fund acquisition. All authors contributed to drafting of the manuscript and critical revisions and agreed to publication of the submitted version of the manuscript.

Corresponding author

Correspondence to Hiroko Kazusaka.

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Conflict of interest

The authors declare that they have no conflict of interest.

Consent participation

Written consent for participation was obtained after agreement based on the informed decision of the patient. This institutional review board of Nippon Medical School also approved this retrospective study using the prospectively collected database in 2019.

Ethical approval

This study was approved by the ethics committee at Nippon Medical School Hospital (Approval No. R1-06-1153).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Kazusaka, H., Sugitani, I., Toda, K. et al. Patient-Reported Outcomes in Patients with Low-Risk Papillary Thyroid Carcinoma: Cross-Sectional Study to Compare Active Surveillance and Immediate Surgery. World J Surg 47, 1190–1198 (2023). https://doi.org/10.1007/s00268-022-06786-5

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  • DOI: https://doi.org/10.1007/s00268-022-06786-5

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