Abstract
BackgroundNowadays, the increasing number of oncologic patients with liver or pancreatic tumours are subjected to surgical treatment, as it can provide a long-term survival or sometimes cure. As a result, numerous new clinical questions regarding metabolic disturbances in these patients have been arisen. Among others, the impact of the pancreas and liver surgery extent in relation to the thyroid function remains to be elucidated.Materials and methodsThe study comprised 51 patients (25 men and 26 women, mean age ± SD 61.6 ± 10.4 yrs, mean ± SD) with pancreatic or liver tumours, qualified for abdominal operation. Serum levels of FT3, FT4 and TSH were measured on the day before (time “0”) and on the 1st, 3rd and 5th day after surgery in two (2) subgroups reflecting the extent of surgery: twenty seven (27) patients (14 men and 13 women, mean age ± SD 61.5 ± 11.8 yrs) after major surgery (Whipple’s surgery, right and left hemihepatectomy, segmentectomy of the liver, distal pancreatectomy, total duodenopancreatectomy) and twenty four (24) patients (11 men and 13 women, mean age ± SD 61.8 ± 8.9 yrs) after minor, palliative surgery (exploratory laparotomy, gastroenterostomy, triple by-pass, liver tumour embolization, hepaticojejunostomy). Additionally, the obtained results were analyzed in relation to the type of the disease (pancreatic surgery vs liver surgery).ResultsMean serum FT3 level decreased significantly during the study in major and minor surgery subgroups (p<0.001, in both) in comparison to the baseline values, accompanied by stable serum concentrations of TSH (NS) and FT4 (NS). The above decreasing tendency in FT3 concentrations was similar in both subgroups (NS), the same as were unchanged levels of TSH (NS) and FT4 (NS). Mean FT4 concentration on the 3rd and 5th day after major surgery was lower in pancreatic tumour patients in comparison to liver tumour patients (p=0.002, p=0.032, respectively). Similarly, mean FT3 concentration on the 3rd day in minor surgery subgroup was lower in pancreatic tumour patients in comparison to liver tumour patients (p=0.015).DiscussionOur findings have confirmed essential reduction of FT3 values after abdominal surgery, independently of surgery extent. Additionally, pancreatic tumour patients are more likely to have lower FT3 and FT4 levels after surgery when compared to liver tumour patients.
Highlights
Nowadays, the increasing number of oncologic patients with liver or pancreatic tumours are subjected to surgical treatment, as it can provide a long-term survival or sometimes cure
The above decreasing tendency in free T3 (FT3) concentrations was similar in both subgroups (NS), the same as were unchanged levels of thyroid stimulating hormone (TSH) (NS) and free T4 (FT4) (NS)
Mean values of FT3, FT4 and TSH on the following days are presented in Table 1 and Table 2
Summary
The increasing number of oncologic patients with liver or pancreatic tumours are subjected to surgical treatment, as it can provide a long-term survival or sometimes cure. Numerous new clinical questions regarding metabolic disturbances in these patients have been arisen. The impact of the pancreas and liver surgery extent in relation to the thyroid function remains to be elucidated. Abnormalities in thyroid hormone metabolism reflect the severity of illness or trauma what speaks in favor of the concept that these syndromes can be used for prognostic purposes [2,4,5]. It is well known that the surgery causes complex metabolic alterations and affects circulating thyroid hormone concentrations, as well [6,7]. The potential impact of various surgical procedures on the thyroid function remains not sufficiently clear. Many new clinical questions regarding metabolic disturbances in these patients have been arisen
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