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Longitudinal Assessment of Quality of Life Following Molecular Testing for Indeterminate Thyroid Nodules

BACKGROUND: Molecular testing can refine the risk of malignancy in cytologically indeterminate thyroid nodules and can reduce the need for diagnostic thyroidectomy. However, quality of life (QOL) in patients mananged with molecular testing is not well studied. OBJECTIVE: We aimed to assess the QOL o...

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Autores principales: Schumm, Max A., Nguyen, Dalena T., Kim, Jiyoon, Tseng, Chi-Hong, Chow, Amy Y., Shen, Na, Livhits, Masha J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8591007/
https://www.ncbi.nlm.nih.gov/pubmed/34292427
http://dx.doi.org/10.1245/s10434-021-10375-6
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author Schumm, Max A.
Nguyen, Dalena T.
Kim, Jiyoon
Tseng, Chi-Hong
Chow, Amy Y.
Shen, Na
Livhits, Masha J.
author_facet Schumm, Max A.
Nguyen, Dalena T.
Kim, Jiyoon
Tseng, Chi-Hong
Chow, Amy Y.
Shen, Na
Livhits, Masha J.
author_sort Schumm, Max A.
collection PubMed
description BACKGROUND: Molecular testing can refine the risk of malignancy in cytologically indeterminate thyroid nodules and can reduce the need for diagnostic thyroidectomy. However, quality of life (QOL) in patients mananged with molecular testing is not well studied. OBJECTIVE: We aimed to assess the QOL of patients undergoing surveillance after a benign molecular test result, or thyroidectomy after a suspicious molecular test result. METHODS: This prospective longitudinal follow-up of the Effectiveness of Molecular Testing Techniques for Diagnosis of Indeterminate Thyroid Nodules randomized trial utilized the Thyroid-Related Patient-Reported Outcome, 39-item version (ThyPro-39) to assess the QOL of patients with indeterminate cytology on thyroid fine needle aspiration (FNA) biopsy. All patients underwent molecular testing at the time of initial FNA. A mixed-effect model was used to determine changes in QOL over time. RESULTS: Of 252 eligible patients, 174 completed the assessment (69% response rate). Molecular test results included 72% (n = 124) benign and 28% (n = 50) suspicious. ThyPro-39 scores of benign molecular test patients were unchanged from baseline (following initial FNA and molecular test results) to 18 months of ultrasound surveillance. Baseline symptoms of goiter, anxiety, and depression were more severe for patients with suspicious compared with benign molecular test results. At a median of 8 months after thyroidectomy, suspicious molecular test patients reported improved symptoms of goiter, anxiety, and depression. CONCLUSION: A benign molecular test provides sustained QOL throughout ultrasound surveillance, without worsening anxiety or depression relating to the risk of malignancy. Definitive surgery results in improvement of QOL in patients with suspicious molecular tests.
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spelling pubmed-85910072021-11-23 Longitudinal Assessment of Quality of Life Following Molecular Testing for Indeterminate Thyroid Nodules Schumm, Max A. Nguyen, Dalena T. Kim, Jiyoon Tseng, Chi-Hong Chow, Amy Y. Shen, Na Livhits, Masha J. Ann Surg Oncol Endocrine Tumors BACKGROUND: Molecular testing can refine the risk of malignancy in cytologically indeterminate thyroid nodules and can reduce the need for diagnostic thyroidectomy. However, quality of life (QOL) in patients mananged with molecular testing is not well studied. OBJECTIVE: We aimed to assess the QOL of patients undergoing surveillance after a benign molecular test result, or thyroidectomy after a suspicious molecular test result. METHODS: This prospective longitudinal follow-up of the Effectiveness of Molecular Testing Techniques for Diagnosis of Indeterminate Thyroid Nodules randomized trial utilized the Thyroid-Related Patient-Reported Outcome, 39-item version (ThyPro-39) to assess the QOL of patients with indeterminate cytology on thyroid fine needle aspiration (FNA) biopsy. All patients underwent molecular testing at the time of initial FNA. A mixed-effect model was used to determine changes in QOL over time. RESULTS: Of 252 eligible patients, 174 completed the assessment (69% response rate). Molecular test results included 72% (n = 124) benign and 28% (n = 50) suspicious. ThyPro-39 scores of benign molecular test patients were unchanged from baseline (following initial FNA and molecular test results) to 18 months of ultrasound surveillance. Baseline symptoms of goiter, anxiety, and depression were more severe for patients with suspicious compared with benign molecular test results. At a median of 8 months after thyroidectomy, suspicious molecular test patients reported improved symptoms of goiter, anxiety, and depression. CONCLUSION: A benign molecular test provides sustained QOL throughout ultrasound surveillance, without worsening anxiety or depression relating to the risk of malignancy. Definitive surgery results in improvement of QOL in patients with suspicious molecular tests. Springer International Publishing 2021-07-22 2021 /pmc/articles/PMC8591007/ /pubmed/34292427 http://dx.doi.org/10.1245/s10434-021-10375-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Endocrine Tumors
Schumm, Max A.
Nguyen, Dalena T.
Kim, Jiyoon
Tseng, Chi-Hong
Chow, Amy Y.
Shen, Na
Livhits, Masha J.
Longitudinal Assessment of Quality of Life Following Molecular Testing for Indeterminate Thyroid Nodules
title Longitudinal Assessment of Quality of Life Following Molecular Testing for Indeterminate Thyroid Nodules
title_full Longitudinal Assessment of Quality of Life Following Molecular Testing for Indeterminate Thyroid Nodules
title_fullStr Longitudinal Assessment of Quality of Life Following Molecular Testing for Indeterminate Thyroid Nodules
title_full_unstemmed Longitudinal Assessment of Quality of Life Following Molecular Testing for Indeterminate Thyroid Nodules
title_short Longitudinal Assessment of Quality of Life Following Molecular Testing for Indeterminate Thyroid Nodules
title_sort longitudinal assessment of quality of life following molecular testing for indeterminate thyroid nodules
topic Endocrine Tumors
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8591007/
https://www.ncbi.nlm.nih.gov/pubmed/34292427
http://dx.doi.org/10.1245/s10434-021-10375-6
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