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Does Clinical and Biochemical Thyroid Dysfunction Impact on Endometrial Cancer Survival Outcomes? A Prospective Database Study

Lookup NU author(s): Dr Salman RazviORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

Abstract: Endometrial cancer is the commonest gynaecological malignancy in developed countries and women presenting with high risk or advanced disease have poor outcomes. Thyroid hormones play a key role in cellular metabolism and can influence cancer growth and invasion. Our aim was to evaluate the association between clinical and biochemical thyroid dysfunction and endometrial cancer survival outcomes. This was a prospective cohort study of women treated for endometrial cancer at a specialist centre. Clinical diagnosis of hypothyroidism was based on clinical and biochemical assessment, verified by general practitioner (GP) records. Pre-treatment serum samples were tested for thyrotropin (TSH), thyroid hormones (free T4 and total T3) and thyroid peroxidase antibodies. Kaplan-Meier survival estimates and log rank tests were used to compare survival between groups while Cox regression was used for multivariable analysis, adjusting for known confounders and effect modifications.. In total, 333 women with a median age and body mass index (BMI) of 66 years (interquartile range (IQR) 56, 73) and 33kg/m2 (IQR 27, 41) respectively were included. Fifty-one (15.3%) women had a diagnosis of hypothyroidism, 39 (11.9%) had biochemical evidence of overt or subclinical hypothyroidism. Median follow-up was 35 months (IQR 21, 45) with 38 (11.7%) relapses and 50 (15.0%) deaths. Women with a diagnosis of hypothyroidism had improved overall survival (adjusted HR=0.22, 95%CI 0.06-0.74, p=0.02), cancer-specific survival (adjusted HR=0.21, 95%CI 0.05-0.98, p=0.04) and fewer recurrences (adjusted HR=0.17, 95%CI 0.04-0.77, p=0.02) than those who did not. Confirmatory studies should explore underlying mechanisms and the potential for therapeutic exploitation.


Publication metadata

Author(s): Barr CE, Njoku K, Hotchkies L, Ryan NAJ, Wan YL, Davies DA, Razvi S, Crosbie EJ

Publication type: Article

Publication status: Published

Journal: Cancers

Year: 2021

Volume: 13

Issue: 21

Online publication date: 29/10/2021

Acceptance date: 27/10/2021

Date deposited: 27/10/2021

ISSN (electronic): 2072-6694

Publisher: MDPI AG

URL: https://doi.org/10.3390/cancers13215444

DOI: 10.3390/cancers13215444


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Funding

Funder referenceFunder name
C147/A25254
CRUK
IS-BRC-1215-20007
MRC
NIHR
MR/M018431/1
NIHR300650

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