Determinants of Health-Related Quality of Life in Differentiated and Poorly Differentiated Thyroid Cancer Patients With Structural Incomplete Response: A Multicenter Cross-Sectional Study

OBJECTIVES: Differentiated and poorly differentiated thyroid cancer (DTC/PDTC) generally carries a favorable prognosis in the absence of persistent or recurrent disease. However, evidence indicates that long-term health-related quality of life (HRQOL) may remain impaired even in patients with good oncological outcomes. Real-world data on HRQOL among DTC/PDTC patients with a structural incomplete response (SIR), including those receiving tyrosine kinase inhibitors, are still limited. This study aimed to investigate the determinants of HRQOL in DTC/PDTC patients with SIR. METHODS: This prospective, multicenter, cross-sectional study enrolled a total of 148 adult participants with a cytologically or histologically confirmed diagnosis of DTC/PDTC and evidence of SIR. All participants completed the self-administered European Organization for Research and Treatment of Cancer questionnaires (EORTC QLQ-C30 and thyroid cancer-specific module QLQ-THY34), as well as the Hospital Anxiety and Depression Scale. RESULTS: Patients with SIR reported significantly reduced HRQOL compared with disease-free survivors, particularly in domains related to fatigue, sleep disturbance, concern for others, exhaustion, and joint pain. Neither disease management strategy (active surveillance vs tyrosine kinase inhibitor or other treatments) nor disease status (stable vs progressive) significantly predicted overall HRQOL. Lower physical functioning, female gender, and higher emotional distress were independently associated with poorer HRQOL, with gender-related differences emerging only among patients with preserved physical functioning. CONCLUSIONS: Despite the absence of a longitudinal design and internal control group, this study emphasizes the importance of systematically assessing HRQOL in DTC/PDTC patients with SIR and highlights the interplay between psychosocial factors and functional status in shaping patient-reported outcomes.