Objective: Quality of life (QoL) has so far seldom been taken into account by default in decision-making for surgical indication in thyroid surgery. Therefore, we compared pre-and postoperative QoL of patients using the EuroQoL-5D (EQ-5D) questionnaire. The influence of certain socio-economic factors on QoL as a second end-point was considered.Design: Prospective cohort study.Patients: About 153 patients with euthyroid symptomatic benign goitre after hemiand total thyroidectomy (follow-up 83.6%) have been included. Measurements:The EQ-5D questionnaire was used prior to and 1 year after surgery.In addition, a questionnaire for assessment of socio-economic status was collected. Results: For n = 90 (n = 67 female, n = 23 male), total thyroidectomy (TT) and, for n = 63 (n = 45 female, n = 18 male), hemithyroidectomy (HT) were performed. None permanent dysfunction of the vocal cord was recorded. Transient symptomatic hypocalcaemia was detected in 9% of the thyroidectomy group (8/90 patients). At follow-up, 86% of patients showed either no change or improved QoL. About 14% of patients complained of deteriorated QoL, regardless of the extent of surgery. Socioeconomic factors did not influence postoperative QoL. Conclusions:Results indicate that in pre-operative consultation of patients with benign goitre, the improvement of QoL should be taken into account for decision-making in cases of ambiguous surgical indication. Contrary to current discussions that too much thyroid surgery is performed in Germany, we can recommend presenting surgery as an equivalent option to watchful waiting as QoL is at least preserved or improved. The extension of the resection should, however, be decided individually. K E Y W O R D SEQ-5D, health-related quality of life, hemithyroidectomy, patient-reported outcome, PRO, QoL, total thyroidectomy

Background: The occurrence of thyroid nodules and goiter increases with age. In general, surgery age is a predictor of perioperative morbidity. In thyroid surgery, there are different data on the role of age on morbidity. We investigated the influence of age on the outcome in thyroid surgery in a prospective single cohort study with a followup after 1 year. Methods: Total thyroidectomy or hemithyroidectomy was performed in euthyroid benign thyroid goiters (n = 152). The primary endpoint was surgery duration. The secondary endpoints were weight of resected tissue, body mass index (BMI), amount and type of perioperative and longterm complications, and quality of life (QoL) preoperatively and 1 year postoperatively.