Surgery: Is it any good for goiter?

Background: Using the thoroughly validated ThyPRO-questionnaire, we aimed at investigating changes in disease-specific quality of life (QoL) following surgical treatment in patients with benign non-toxic nodular goiter. Method: Patients with goiter scheduled for thyroid surgery (n=106) and individuals from the general population (n=739) were studied. ThyPRO data before, three, and six months after surgery were compared with normative scores from the general population using a linear mixed model and t-tests. Effect sizes (ES) were calculated as mean change divided by standard deviation at baseline. ES of 0.2-0.5 were defined as small, 0.5-0.8 as moderate, and values > 0.8 as large. Results: Before surgery, patients with goiter experienced poorer scores on all scales compared to the general population (p<0.01). Three months after surgery, moderate improvements were seen in Goiter Symptoms ((ES: 1.26, p<0.001) and Overall QoL (ES: 0.56, p<0.001). Six months after surgery, moderate to large improvements were seen in Goiter Symptoms (ES: 1.52, p<0.001), Tiredness (ES: 0.60, p<0.001), Anxiety (ES: 0.54, p<0.001), and Overall QoL (ES: 0.74, p<0.001). At this time point, all scales had returned to levels as those found in the general population. The degree of Anxiety was in fact lower than in the general population. Discussion: Using a thoroughly validated questionnaire, in an adequately powered study, we demonstrated that surgery profoundly improves QoL in patients with benign non-toxic nodular goiter. Our study may contribute important information for the patient as well as for the physician in guidance of choice of treatment, and what effects to expect as for various aspects of QoL.