Factors influencing the quality of life in survivors of differentiated thyroid cancer based on patient-reported outcomes: a single-center cross-sectional study.

Purpose: While the prognosis for differentiated thyroid cancer (DTC) is favorable, the health-related quality of life (QOL) of survivors is not well understood. This study aims to investigate the factors influencing the QOL of DTC survivors. Methods: A total of 860 DTC survivors who underwent thyroidectomy were surveyed. Participants completed the Chinese version of the Thyroid Cancer-Specific Quality of Life (THYCA-QOL) questionnaire, the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire-C30 (EORTC QLQ-C30), and additional related questions. Multivariate regression analyses identified factors affecting survivors' QOL. Results: Among the survivors, 65 patients (7.6%) reported long-term postoperative complaints, including fatigue, throat discomfort, neck/shoulder stiffness, weight gain, and insomnia, among others. The average THYCA-QOL summary score was 20.29, with the highest scores in problems with scar, psychological problems, gained weight, less interest in sex, and sympathetic problems. The average EORTC QLQ-C30 summary score was 82.59, with lower scores for emotional and cognitive on the functional scales, and higher scores for fatigue and insomnia on the symptom scales. Women, BMI ≥ 28, higher T-stage (T3 + 4), permanent hypoparathyroidism, recurrence reoperation, and more postoperative complaints were associated with poorer thyroid cancer-specific QOL, while age over 45 years was associated with better QOL. Longer postoperative follow-up (>6 months) and drinking were correlated with higher QLQ-C30 summary scores, while recurrence reoperation and postoperative complaints were associated with worse QOL. Conclusions: The QOL of DTC survivors is influenced by multiple factors, with some patients experiencing long-term complaints. Attention to the QOL and postoperative complaints in DTC survivors is essential.