Impact of Scar on Quality of Life in Well-Differentiated Thyroid Carcinoma: A Systematic Review.

Objective: Remote access techniques in thyroid surgery have been developed to improve cosmetic outcomes, based on the presumed impact of surgical scars on patients' quality of life (QoL). This systematic review aimed to evaluate the impact of surgical scars on the overall QoL of patients who have undergone thyroidectomy for low-risk thyroid carcinoma. The review focuses on the rank of scar-related QoL issues relative to other aspects assessed by validated QoL instruments.

Data sources: MEDLINE, EMBASE, CENTRAL, LILACS, Google Scholar (no language or time restrictions).

Review methods: A systematic review was conducted for original articles using validated QoL instruments with scar-related domains in thyroid cancer patients who had undergone OT. Study quality was assessed using the JBI critical appraisal tool for cross-sectional studies. Data were analyzed from 14 patient groups across 9 studies, representing 3658 patients.

Results: In 12 of 14 samples, scar-related issues ranked lower than sixth place in QoL assessments, with 7 samples placing scar-related items at the lowest position. The Thyca-Qol questionnaire was the most commonly used tool, though most studies had limitations, including selection and recall biases. However, across geographically and culturally diverse populations, scar-related concerns consistently ranked lower in importance compared to other QoL factors.

Conclusions: The impact of surgical scars on QoL in thyroid cancer survivors is low, with scar-related items ranking among the least significant issues. Remote access techniques designed primarily for cosmetic outcomes should demonstrate additional benefits to justify their use.