5 research outputs found
Long-term quality of life in adult survivors of pediatric differentiated thyroid carcinoma
Context: Little is known about long-term quality of life (QoL) of survivors of pediatric differentiated
thyroid carcinoma. Therefore, this study aimed to evaluate generic health-related QoL (HRQoL),
fatigue, anxiety, and depression in these survivors compared with matched controls, and to evaluate
thyroid cancer–specific HRQoL in survivors only.
Design: Survivors diagnosed between 1970 and 2013 at age #18 years, were included. Exclusion
criteria were a follow-up ,5 years, attained age ,18 years, or diagnosis of DTC as a second
malignant neoplasm (SMN). Controls were matched by age, sex, and socioeconomic status. Survivors
and controls were asked to complete 3 questionnaires [Short-Form 36 (HRQoL), Multidimensional
Fatigue Inventory 20 (fatigue), and Hospital Anxiety and Depression Scale (anxiety/depression)].
Survivors completed a thyroid cancer–specific HRQoL questionnaire.
Results: Sixty-seven survivors and 56 controls. Median age of survivors at evaluation was
34.2 years (range, 18.8 to 61.7). Median follow-up was 17.8 years (range, 5.0 to 44.7). On most
QoL subscales, scores of survivors and controls did not differ significantly. However, survivors
had more physical problems (P = 0.031), role limitations due to physical problems (P = 0.021),
and mental fatigue (P = 0.016) than controls. Some thyroid cancer–specific complaints (e.g.,
sensory complaints and chilliness) were present in survivors. Unemployment and more extensive
disease or treatment characteristics were most frequently associated with worse QoL.
Conclusions: Overall, long-term QoL in survivors of pediatric DTC was normal. Survivors experienced
mild impairment of QoL in some domains (physical problems, mental fatigue, and various thyroid
cancer–specific complaints). Factors possibly affecting QoL need further exploration
Effect of neoadjuvant chemoradiotherapy on health-Related quality of life in esophageal or junctional cancer: Results from the randomized CROSS trial
Purpose To compare pre-agreed health-related quality of life (HRQOL) domains in patients with esophageal or junctional cancer who received neoadjuvant chemoradiotherapy (nCRT) followed by surgery or surgery alone. Secondary aims were to examine the effect of nCRT on HRQOL before surgery and the effect of surgery on HRQOL. Patients and Methods Patients were randomly assigned to nCRT (carboplatin plus paclitaxel with concurrent 41.4-Gy radiotherapy) followed by surgery or surgery alone. HRQOL was measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire–Core 30 (QLQ-C30) and –Oesophageal Cancer Module (QLQ-OES24) questionnaires pretreatment and at 3, 6, 9, and 12 months postoperatively. The nCRT group also received preoperative questionnaires. Physical functioning (PF; QLQ-C30) and eating problems (EA; QLQ-OES24) were chosen as predefined primary end points. Predefined secondary end points were global QOL (GQOL; QLQ-C30), fatigue (FA; QLQ-C30), and emotional problems (EM; QLQ-OES24). Results A total of 363 patients were analyzed. No statistically significant differences in postoperative HRQOL were found between treatment groups. In the nCRT group, PF, EA, GQOL, FA, and EM scores deteriorated 1 week after nCRT (Cohen’s d: 20.93, P, .001; 0.47, P, .001; 20.84, P, .001; 1.45, P, .001; and 0.32, P = .001, respectively). In both treatment groups, all end points declined 3 months postoperatively compared with baseline (Cohen’s d: 21.00, 0.33, 20.47, 20.34, and 0.33, respectively; all P, .001), followed by a continuous gradual improvement. EA, GQOL, and EM were restored to baseline levels during follow-up, whereas PF and FA remained impaired 1 year postoperatively (Cohen’s d: 0.52 and 20.53, respectively; both P, .001). Conclusion Although HRQOL declined during nCRT, no effect of nCRT was apparent on postoperative HRQOL compared with surgery alone. In addition to the improvement in survival, these findings support the view that nCRT according to the Chemoradiotherapy for Esophageal Cancer Followed by Surgery Study–regimen can be regarded as a standard of care
Characteristics of contralateral carcinomas in patients with differentiated thyroid cancer larger than 1Â cm
Purpose: Traditionally, total thyroidectomy has been advocated for patients with tumors larger than 1Â cm. However, according to the ATA and NCCN guidelines (2015, USA), patients with tumors up to 4Â cm are now eligible for lobectomy. A rationale for adhering to total thyroidectomy might be the presence of contralateral carcinomas. The purpose of this study was to describe the characteristics of contralateral carcinomas in patients with differentiated thyroid cancer (DTC) larger than 1Â cm. Methods: A retrospective study was performed including patients from 17 centers in 5 countries. Adults diagnosed with DTC stage T1b-T3 N0-1a M0 who all underwent a total thyroidectomy were included. The primary endpoint was the presence of a contralateral carcinoma. Results: A total of 1