Determinants of long-term quality of life in patients with differentiated thyroid carcinoma - a population-based cohort study in Sweden
Determinants of long-term quality of life in patients with differentiated thyroid carcinoma - a population-based cohort study in Sweden
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DOI：
10.3109/0284186x.2015.1102965
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发表时间：
2016-03-03
期刊：
影响因子：
3.1
通讯作者：
Lundgren, Catharina Ihre
中科院分区：
文献类型：
--
作者：
Hedman, Christel;Djarv, Therese;Lundgren, Catharina Ihre
背景资料：虽然分化型甲状腺癌（DTC）预后良好，复发率低，但可能需要终身随访和药物治疗。本研究的目的是澄清如何生活与癌症诊断多年影响健康相关的生活质量（HRQoL）在DTC患者在瑞典。材料和方法：从国家全面的基于人群的瑞典癌症登记处，确定了1995年至1998年期间诊断为DTC的353例患者，并邀请他们回答HRQoL问卷SF-36和研究特定问卷，确诊后14-17年。数据进行了比较与参考人群以及亚组之间的patients.Results：DTC患者，279（79%）回答了问卷。总体而言，只有19例（7%）报告复发，然而，多达134例（48%）表示他们仍然担心复发。在8个领域中的5个领域，复发患者的HRQoL显著低于无复发担忧的患者（p < 0.001-0.049）。同样，有复发顾虑的患者报告的HRQoL比无复发顾虑的患者差，在五个领域的数值显著较低（p < 0.001-0.008）。那些少数谁说，他们的疾病给了他们一个负面的看法，生活在所有八个领域的报告差HRQoL（p < 0.001-0.030）结论：即使DTC来与一个良好的预后，几乎一半的患者，完全15年后诊断，担心复发的负面影响他们的HRQoL。医疗从业人员的认识可能会改善信息，支持性护理，并在最后，病人的HRQoL。
Background: Although differentiated thyroid cancer (DTC) has an excellent prognosis and a low incidence of recurrence, lifelong follow-up and medication might be needed. The aim of this study was to clarify how living with a cancer diagnosis for many years affects health-related quality of life (HRQoL) in DTC patients in Sweden.Material and methods: From the national all-encompassing population-based Swedish Cancer Registry, 353 patients diagnosed with DTC between 1995 and 1998 were identified and invited to answer the HRQoL questionnaire SF-36 and a study-specific questionnaire, 14-17 years after their diagnosis. Data were compared with a reference population as well between subgroups of patients.Results: Of the patients with DTC, 279 (79%) answered the questionnaires. In all, only 19 (7%) reported a recurrence, however, as many as 134 (48%) stated that they still had concerns about having a recurrence. The HRQoL in those with a recurrence was significantly lower than those without concerns of a recurrence in five of eight domains (p < 0.001-0.049). Similarly, patients with concerns of a recurrence reported poorer HRQoL than those without concerns, with significantly lower values in five domains (p < 0.001-0.008). Those few who stated that their disease had given them a negative view on life reported poor HRQoL in all eight domains (p < 0.001-0.030).Conclusions: Even if DTC comes with an excellent prognosis, almost half of the patients, fully 15 years after diagnosis, worried about a recurrence which negatively impacted their HRQoL. Awareness among healthcare practitioners might improve information, supportive care and, in the end, the patient's HRQoL.