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

Barr, Chloe E.; Njoku, Kelechi; Hotchkies, L; Ryan, Neil; Wan, Y. Louise; Davies, David; Razvi, Salman; Crosbie, Emma J.

doi:10.3390/cancers13215444

Cited by 7 publications

(9 citation statements)

References 54 publications

(65 reference statements)

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“…Management algorithms also take age, body mass index (BMI) and comorbid status into consideration [ 3 ]. However, there is emerging evidence that prognosis is influenced by factors other than traditional clinico-pathological parameters, and that these may help to refine endometrial cancer risk assessment [ 4 , [8] , [9] , [10] ].…”

Section: Introductionmentioning

confidence: 99%

Pre-treatment inflammatory parameters predict survival from endometrial cancer: A prospective database analysis

Njoku

Ramchander

Wan

et al. 2022

Gynecologic Oncology

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Purpose Inflammation predisposes to tumorigenesis by damaging DNA, stimulating angiogenesis and potentiating pro-proliferative and anti-apoptotic processes. The aim of this study was to investigate whether pre-treatment biomarkers of systemic inflammation are associated with survival outcomes in endometrial cancer. Patients and methods Women with endometrial cancer were recruited to a prospective database study. Pre-treatment systemic markers of inflammation, including C-reactive protein (CRP), Glasgow Prognostic Score and lymphocyte-based ratios [neutrophil-lymphocyte ratio (NMR), monocyte-lymphocyte ratio (MLR), systemic immune-inflammation index (SII)], were analysed in relation to overall, endometrial cancer-specific and recurrence-free survival using Kaplan-Meier estimation and multivariable Cox regression. Results In total, 522 women of mostly White British ethnicity, with a median age of 66 years (interquartile range (IQR), 56, 73) and BMI of 32 kg/m 2 (IQR 26, 39) were included in the analysis. Most had low-grade (67.2%), early-stage (85.4% stage I/II), endometrioid (74.5%) tumors. Women with pre-treatment CRP ≥5.5 mg/L had a 68% increase in overall (adjusted HR = 1.68, 95% CI 1.00–2.81, p = 0.049) and a two-fold higher cancer-specific mortality risk than those with CRP <5.5 mg/L (adjusted HR = 2.04, 95%CI 1.03–4.02, p = 0.04). Absolute lymphocyte count, NLR, MLR and SII were associated with adverse clinico-pathologic factors, but not overall, cancer-specific or recurrence-free survival in the multivariable analysis. Conclusion If confirmed in an independent cohort, CRP may offer a simple, low-cost test to refine pre-treatment risk assessment and guide personalised care in endometrial cancer. Our participants were mostly of White British ethnicity and further studies are needed to confirm the utility of CRP as a prognostic biomarker in other populations.

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Section: Introductionmentioning

confidence: 99%

Pre-treatment inflammatory parameters predict survival from endometrial cancer: A prospective database analysis

Njoku

Ramchander

Wan

et al. 2022

Gynecologic Oncology

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“…У самок основной группы в крови уровень общих форм тиреоидных гормонов был ниже, чем у интактных животных Т4 2,3 раза и Т3 в 1,9 раза. Концен- Контрольная группа № 2 11,25 ± 0,14 1 4,17 ± 0,11 28,12 ± 0,79 1 1,76 ± 0,08 1 0,07 ± 0,004 2 Основная группа 8,85 ± 0,34 1,2,3 3,5 ± 0,13 1,2 26,70 ± 0,92 1,2 0,55 ± 0,02 15,98 ± 0,64 1,2 0,72 ± 0,03 1,2 0,140 ± 0,005 1 Основная группа 5,72 ± 0,35 1,2,3 1,85 ± 0,08 1,2,3 11,32 ± 0,48 1,2,3 0,52 ± 0,03 1,2,3 0,310 ± 0,011 1,2,3 Примечание: значимые различия по сравнению: 1 -с интактными животными соответствующего пола; 2 -с контрольной группой № 1; 3 -с контрольной группой № 2 (р < 0,05).…”

Section: результаты исследованияunclassified

“…Установлено, что у самок крыс контрольных и основной групп в щитовидной железе в разной степени выраженности найдено снижение уровня Т4 и Т3, на фоне нормального содержания ТТГ в контрольных группах и повышения в 2,9 раза в основной группе. Максимальное снижение уровня общих форм Т4 и Т3 в щитовидной железе -в 24,2 раза и 51,3 раза установлено в контрольной группе № 1, у самок крыс контрольной группы № 2 и основной Интактная 42,57 ± 2,24 0,28 ± 0,015 30,7 ± 1,78 0,25 ± 0,015 Контрольная 1 14,6 ± 0,56 1,3 0,28 ± 0,019 14,2 ± 0,64 1,3 0,35 ± 0,012 1,3 Контрольная 2 20,5 ± 1,21 ных, а FT3 в щитовидной железе самок было ниже в 1,9 раза. У самцов крыс с гипотиреозом самостоятельным и сочетанным с опухолевым ростом в щитовидной железе также отмечено сниженное содержание общих и свободных форм тиреоидных гормонов.…”

Section: результаты исследованияunclassified

Changes in pathophysiology of tumor growth and functional activity of the hypothalamic-pituitary-thyroid axis in rats of both sexes with the development of Guerin's carcinoma on the background of hypothyroidism

Frantsiyants¹,

Бандовкина²,

Kaplieva³

et al. 2022

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Purpose of the study. Was to analyze changes in pathophysiological parameters of transplantable tumor growth and functional activity of the hypothalamic-pituitary-thyroid axis (HPT) in rats of both sexes with Guerin's carcinoma in presence of induced hypothyroidism.Materials and methods. The dynamics of tumor growth and average life span were assessed in white alley rats of both sexes with Guerins carcinoma transplanted subcutaneously on the background of thyreostatic induced hypothyroidism. RIA (radioimmune assay) and ELISA (enzyme-linked immunosorbent assay) methods were used to determine levels of thyroid hormones in the blood and thyroid and tumor samples, and thyrotropin-releasing hormone (TRH) in the hypothalamus, as well as TSH in the pituitary gland. The experiment included 2 control groups: animals of both sexes with hypothyroidism (control group 1, number of rodents = 15) and animals with subcutaneously transplanted Guerin's carcinoma without hypothyroidism (control group 2, number of rodents = 15).Results. Hypothyroidism in female rats inhibited the tumor growth and improved median survival by 1.8 times (p < 0.05). No such effect was observed in males of the main group. Levels of regulatory peptides of the hypothalamus and pituitary gland declined in females of the main group, while levels of TSH in the pituitary gland in males increased, despite a decrease in TRH by 3.5 times. TSH levels decreased in the thyroid and blood of animals of both sexes; however, a decrease in levels of total and free circulating thyroxine (T4 and FT4) by 1.6 times and by 2.8 times was found in the tumor, respectively; samples of Guerin's carcinoma in males of the main group remained saturated with T4 and FT4 as well as and in control group rodents without induced hypothyroidism.Conclusions. The gender differences in the pathophysiology of the tumor development in presence of hypothyroidism, as well as changes in the functional activity of the HPT axis in experimental animals revealed in this study can probably be associated with sex hormones, which requires further study of the hypothalamic-pituitary-gonadal (HPG) axis and steroid hormones in peripheral organs and tumor samples.

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“…SCH was associated with a 69% reduced risk of death (HR, 0.31; 95% CI, 0.09–1.28) compared to euthyroidism. After adjustment for confounding factors, SCH was associated with a 46% reduced risk of death (HR, 0.54; 95% CI, 0.12–2.43) compared to euthyroid women [ 100 ].…”

Section: Clinical Data On Hypothyroidism As a Potential Prognostic Fa...mentioning

confidence: 99%

The Clinical Relevance of Hypothyroidism in Patients with Solid Non-Thyroid Cancer: A Tantalizing Conundrum

Deligiorgi

Trafalis

2022

JCM

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Hypothyroidism in patients with solid non-thyroid cancer is a tantalizing entity, integrating an intriguing thyroid hormones (THs)–cancer association with the complexity of hypothyroidism itself. The present narrative review provides a comprehensive overview of the clinical relevance of hypothyroidism in solid non-thyroid cancer. Hypothyroidism in patients with solid non-thyroid cancer is reminiscent of hypothyroidism in the general population, yet also poses distinct challenges due to the dual role of THs in cancer: promoting versus inhibitory. Close collaboration between oncologists and endocrinologists will enable the prompt and personalized diagnosis and treatment of hypothyroidism in patients with solid non-thyroid cancer. Clinical data indicate that hypothyroidism is a predictor of a decreased or increased risk of solid non-thyroid cancer and is a prognostic factor of favorable or unfavorable prognosis in solid non-thyroid cancer. However, the impact of hypothyroidism with respect to the risk and/or prognosis of solid non-thyroid cancer is not a consistent finding. To harness hypothyroidism, or THs replacement, as a personalized anticancer strategy for solid non-thyroid cancer, four prerequisites need to be fulfilled, namely: (i) deciphering the dual THs actions in cancer; (ii) identifying interventions in THs status and developing agents that block tumor-promoting THs actions and/or mimic anticancer THs actions; (iii) appropriate patient selection; and (iv) counteracting current methodological limitations.

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

Cited by 7 publications

References 54 publications

Pre-treatment inflammatory parameters predict survival from endometrial cancer: A prospective database analysis

Pre-treatment inflammatory parameters predict survival from endometrial cancer: A prospective database analysis

Changes in pathophysiology of tumor growth and functional activity of the hypothalamic-pituitary-thyroid axis in rats of both sexes with the development of Guerin's carcinoma on the background of hypothyroidism

The Clinical Relevance of Hypothyroidism in Patients with Solid Non-Thyroid Cancer: A Tantalizing Conundrum

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