Abstract
Simple SummaryThyroid hormones are surmised to be associated with cancer. However, so far, there is no sufficient data on the association of thyroid hormone status as well as replacement therapy in patients with upper gastrointestinal cancer Thus, we analyzed clinical as well as endocrinological parameters of 865 patients with resectable gastroesophageal cancer treated at the Medical University of Vienna, which is a large representative European cohort. A tendency towards prolonged overall survival in hypothyroid patients (euthyroid, n = 647: median OS 29.7 months; hyperthyroid, n = 50: 23.1 months; hypothyroid, n = 70: 47.9 months; p = 0.069) as well as a significant positive correlation of thyroid hormone replacement therapy with the overall survival was observed (without, n = 53: median OS 30.6 months; with, n = 67: 51.3 months; p = 0.017). Thus, thyroid disorders and their therapeutic interventions might pose as potential prognostic tools and further prospective analyses are warranted.Introduction: As thyroid hormones modulate proliferative pathways it is surmised that they can be associated with cancer development. Since the potential association of gastroesophageal cancer and thyroid disorders has not been addressed so far, the aim of this study was to investigate the association of thyroid hormone parameters with the outcome of these patients, so novel prognostic and even potentially therapeutic markers can be defined. Material and Methods: Clinical and endocrinological parameters of patients with resectable gastroesophageal cancer treated between 1990 and 2018 at the Vienna General Hospital, Austria, including history of endocrinological disorders and laboratory analyses of thyroid hormones at first cancer diagnosis were investigated and correlated with the overall survival (OS). Results: In a total of 865 patients, a tendency towards prolonged OS in hypothyroid patients (euthyroid, n = 647: median OS 29.7 months; hyperthyroid, n = 50: 23.1 months; hypothyroid, n = 70: 47.9 months; p = 0.069) as well as a significant positive correlation of thyroid hormone replacement therapy with the OS was observed (without, n = 53: median OS 30.6 months; with, n = 67: 51.3 months; p = 0.017). Furthermore, triiodothyronine (T3) levels were also associated with the OS (median OS within the limit of normal: 23.4, above: 32.4, below: 9.6 months; p = 0.045). Conclusions: Thyroid disorders and their therapeutic interventions might be associated with the OS in patients with resectable gastroesophageal cancer. As data on the correlation of these parameters is scarce, this study proposes an important impulse for further analyses concerning the association of thyroid hormones with the outcome in patients with gastroesophageal tumors.
Highlights
As thyroid hormones modulate proliferative pathways it is surmised that they can be associated with cancer development
Further analysis was performed on 865 patients with resectable gastroesophageal cancer
We observed: (i) an almost equal number of gastroesophageal junctions (32.5%) and gastric tumors (39.9%), which is opposite to the Asian populations, where the gastric cases are in the majority; (ii) 70.2% of the included patients in this study were male and (iii) the majority (78.7%) of the observed carcinomas were adenocarcinomas
Summary
As thyroid hormones modulate proliferative pathways it is surmised that they can be associated with cancer development. Since the potential association of gastroesophageal cancer and thyroid disorders has not been addressed so far, the aim of this study was to investigate the association of thyroid hormone parameters with the outcome of these patients, so novel prognostic and even potentially therapeutic markers can be defined. Cancers of the upper gastrointestinal (GI) tract including gastric, esophageal, and gastroesophageal junction (GEJ) cancer are among the most common and deadly malignant diseases worldwide [1] Survival in these patients is generally poor and reliable prognostic markers are scarce, especially in European cohorts [2]. The aim of this study was to investigate the association of thyroid hormone parameters with the outcome of patients with resectable gastroesophageal tumors, so potential, novel prognostic markers can be defined
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