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Patients' View on the Management of Papillary Thyroid Microcarcinoma: Active Surveillance or Surgery
- Source :
- Thyroid
- Publication Year :
- 2020
- Publisher :
- Mary Ann Liebert, Inc., publishers, 2020.
-
Abstract
- Background: Clinical practice guidelines have endorsed both active surveillance and surgery as viable management options for papillary thyroid microcarcinoma (PTMC). However, patients' perceptions on the options have rarely been addressed. Methods: A cross-sectional survey was conducted on 50 patients with PTMC who were under either active surveillance (n = 20) or postoperative follow-up (n = 30). The primary outcome was anxiety, which was measured using the State-Trait Anxiety Inventory (STAI). A questionnaire that comprised six items about PTMC-related symptoms and concerns, which were measured with a visual analog scale, was also administered. Cohen's d effect size was calculated to express group differences. Multiple regression analysis was used to examine the relationships between state anxiety and other variables. Results: The median age and observation period were 61.5 years (range, 40–83 years) and 4.1 years (range, 0–8.6 years), respectively. The female/male ratio was 38/12. Compared with the surgery group, the active surveillance group showed higher scores in both state anxiety and trait anxiety, with corresponding effect sizes of 0.55 (confidence interval [CI] −0.03 to 1.1; p = 0.068) and 0.63 (CI 0.02–1.2; p = 0.037), respectively. Trait anxiety (β = 0.83) and observation time (β = −1.57) were the significant predictors of state anxiety. Moderate effect sizes were observed for “discomfort in the neck” (−0.53; CI −1.11 to 0.04); “weak voice” (−0.46; CI −1.03 to 0.12); and “nervous about neck appearance” (−0.64; CI −1.23 to −0.07), in favor of active surveillance. Conclusions: State anxiety among patients with PTMC seemed to be a reflection of an individual's trait rather than management. Understanding the patients' view appears to be key to improve shared decision-making.
- Subjects :
- Adult
Male
medicine.medical_specialty
genetic structures
Endocrinology, Diabetes and Metabolism
effect size
Papillary Thyroid Microcarcinoma
030209 endocrinology & metabolism
patient-reported outcome
03 medical and health sciences
0302 clinical medicine
Endocrinology
Surveys and Questionnaires
medicine
Humans
papillary thyroid microcarcinoma
Thyroid Neoplasms
Watchful Waiting
Aged
Retrospective Studies
Aged, 80 and over
business.industry
active surveillance
Thyroid Cancer and Nodules
Middle Aged
Surgery
Clinical Practice
Cross-Sectional Studies
Thyroid Cancer, Papillary
030220 oncology & carcinogenesis
Thyroidectomy
Patient-reported outcome
Female
business
Subjects
Details
- Language :
- English
- ISSN :
- 15579077 and 10507256
- Volume :
- 30
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Thyroid
- Accession number :
- edsair.doi.dedup.....75ef5f3d316d01fb5b2bd9e060116fdb