• Alexis G Antunez, Brandy R Sinco, Megan C Saucke, Kyle J Bushaw, Catherine B Jensen, Sophie Dream, Abbey L Fingeret, Masha J Livhits, Aarti Mathur, Alexandria McDow, Sanziana A Roman, Corrine I Voils, Justin Sydnor, Susan C Pitt, and CHOiCE Collaborative (Comparing Health Outcomes in Cancer Experience).
• Brigham and Women's Hospital.
• Ann. Surg. 2024 May 20.

ObjectiveTo evaluate the relative importance of treatment outcomes to patients with low-risk thyroid cancer (TC).Summary Background DataOveruse of total thyroidectomy (TT) for low-risk TC is common. Emotions from a cancer diagnosis may lead patients to choose TT resulting in outcomes that do not align with their preferences.MethodsAdults with clinically low-risk TC enrolled in a prospective, multi-institutional, longitudinal cohort study from 11/2019-6/2021. Participants rated treatment outcomes at the time of their surgical decision and again 9 months later by allocating 100 points amongst 10 outcomes. T-tests and Hotelling's T 2 statistic compared outcome valuation within and between subjects based on chosen extent of surgery (TT vs. lobectomy).ResultsOf 177 eligible patients, 125 participated (70.6% response) and 114 completed the 9-month follow-up (91.2% retention). At the time of the treatment decision, patients choosing TT valued the risk of recurrence more than those choosing lobectomy and the need to take thyroid hormone less ( P <0.05). At repeat valuation, all patients assigned fewer points to cancer being removed and the impact of treatment on their voice, and more points to energy levels ( P <0.05). The importance of the risk of recurrence increased for those who chose lobectomy and decreased for those choosing TT ( P <0.05).ConclusionThe relative importance of treatment outcomes changes for patients with low-risk TC once the outcome has been experienced to favor quality of life over emotion-related outcomes. Surgeons can use this information to discuss the potential for asthenia or changes in energy levels associated with total thyroidectomy.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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