Health-Related Quality of Life and Cosmesis After Thyroidectomy: Long-Term Outcomes

Health-related quality of life (HRQoL) after thyroidectomy has been recently reported with conflicting conclusions. In this study, we assess HRQoL and neck scar cosmesis of thyroid patients several years after thyroidectomy for benign and malignant pathology.

Three hundred and thirty patients who underwent thyroidectomy between 2000 and 2010 answered the SF-36 Health Survey and Patient Scar Assessment Questionnaire (PSAQ) in 2010 and at the end of 2018. Changes in the SF-36 and PSAQ scores were analyzed taking into account various demographic, surgical and medical characteristics of the patients.

Patients reported worse SF-36 scores after 8.5 years, in scales of physical functioning (p < 0.001), social role functioning (p = 0.002), bodily pain (p = 0.001) and general health perceptions (p < 0.001). Interestingly enough, there were no significant changes in scales of physical role functioning (p = 0.304), mental health (p = 0.681), emotional role functioning (p = 0.903) and vitality (p = 0.121). Multivariate analysis showed that several chronic diseases were related to worse HRQoL scores. On the other hand, PSAQ appearance, symptoms and consciousness scores improved during this period (p < 0.001).

In the long term, patients undergoing thyroidectomy do not show worse HRQoL outcomes in terms of mental health, emotional functioning and vitality, whereas scar cosmesis perception is improved. They show deteriorated outcomes in terms of physical, social functioning and bodily pain, which is mainly related to specific chronic diseases that are common to the aging person.