Postoperative Anxiety in Childbearing-Age Women with PTMC: Comparison Between Traditional Surgery and Thermal Ablation.

Objective: To compare postoperative anxiety in childbearing-age women with PTMC undergoing traditional surgery and thermal ablation, and identify influencing factors.

Methods: This retrospective cohort study included 118 women of childbearing age who underwent surgery for papillary thyroid microcarcinoma (PTMC) between January and December 2023. Postoperative anxiety symptoms and their influencing factors were prospectively assessed during follow-up visits using standardized questionnaires: the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Self-Rating Anxiety Scale (SAS), the Thyroid Cancer-Specific Health-Related Quality of Life Questionnaire (THYCA-QoL), and the Reproductive Health Literacy Scale. Demographic characteristics and clinical data were analyzed using univariate analysis and multiple linear regression models to identify risk factors.

Results: Postoperative anxiety was significantly associated with long-term levothyroxine use (β=0.405, p=0.011) and surgical approach. Traditional surgery patients demonstrate higher physical health (2.50 vs 1.50, p<0.001) and social/family scores (2.17 vs 1.50, p<0.001) than the ablation group parallels greater levothyroxine dependency (89.4% vs 15.2%, p<0.001). Symptom-anxiety correlations differed between groups: traditional surgery was associated with multidimensional drivers (voice changes r=0.572, weight gain r=0.488), whereas thermal ablation primarily correlated with transient voice changes (r=0.507).

Conclusion: The multidimensional anxiety after traditional surgery originates from thyroid dysfunction and complications, whereas thermal ablation is associated with a lower psychological burden with manageable short-term symptoms. Treatment selection should be individualized prioritizing reproductive timelines and individualized risk-benefit profiles.