Abstract
The THYCA-QoL 24 is a specific instrument designed to measure health-related quality of life (HRQoL) in patients with thyroid cancer (TC). This study aimed to evaluate the Vietnamese version of the THYCA-QoL (acceptability, validity, and reliability) and use this validated version to systematically assess longitudinal changes in HRQoL in this patient population before and after thyroidectomy, including adjuvant radioactive iodine (RAI) therapy to understand the impact of surgical intervention over time. The study was conducted in three steps: translation, validation, and evaluation of the THYCA-QoL questionnaire for the Vietnamese population. This process followed the EORTC guidelines. Internal consistency was measured using Cronbach's α, while convergent validity and internal structure of the scale were examined through Pearson correlation analysis. HRQoL data were collected from thyroid cancer patients, at a leading hospital in Southern Vietnam. A cohort comprising 280 patients was enrolled in this study. All participants presented with disease stage I or II at baseline assessment. Evaluation of the psychometric properties of the Vietnamese version of the Thyca-QoL revealed robust internal consistency (Cronbach's alpha = 0.937 for the overall scale) and a satisfactory scale-level Content Validity Index (S-CVI = 0.97). No statistically significant difference was observed in overall QoL scores between the pre-operative baseline and the 3-month post-operative assessment across most physical symptoms. Overall QoL scores did not differ significantly between the radioactive iodine (RAI) treatment group and the non-RAI group; however, within the RAI cohort, QoL impairment was primarily attributable to increased symptom burden, specifically problem swallowing, dry mouth, and abrupt tiredness. Patients undergoing total thyroidectomy reported higher mean symptom scores than those undergoing lobectomy, particularly in domains related to scarring and fatigue (p = 0.001). Multivariate analysis revealed that the presence of comorbidities (p = 0.01) and age (p = 0.04) were independently associated with poorer HRQoL. HRQoL assessment following thyroid cancer surgery is crucial for delivering patient-centered care, improving treatment outcomes, and advancing our understanding of this disease and its consequences for survivors.