Clinical History of Hypothyroidism Linked to Endometrial Cancer Survival Outcomes

Dawn O'Shea

November 29, 2021

A team of researchers from Newcastle University and Manchester University Foundation Trust have discovered an association between a clinical history of hypothyroidism and endometrial cancer survival outcomes.

The prospective cohort study included women treated for endometrial cancer in the North West of England. Diagnosis of hypothyroidism was based on clinical and biochemical assessment, which were verified by GP records. Pre-treatment serum samples were tested for thyrotropin (TSH), thyroid hormones (free T4 and total T3), and thyroid peroxidase antibodies.

In total, 333 women with median age of 66 years (interquartile range [IQR] 56 to 73) and median BMI of 33 kg/m2 (IQR 27, 41) were included.

A total of 51 (15.3%) women had a prior diagnosis of hypothyroidism and a further 39 (11.9%) had biochemical evidence of overt or subclinical hypothyroidism.

Median follow-up was 35 months (IQR 21,45), during which there were 38 (11.7%) relapses and 50 (15.0%) deaths.

Women with a diagnosis of hypothyroidism had improved overall survival (adjusted hazard ratio [HR] 0.22; 95% CI 0.06 to 0.74; P=0.02) and endometrial cancer-specific survival (adjusted HR 0.21; 95% CI 0.05 to 0.98; P=0.04), and fewer recurrences (adjusted HR = 0.17; 95% CI 0.04 to 0.77; P=0.02) than those who did not.

After adjustment for known confounders, there was no statistically significant evidence of an association between survival outcomes and biochemical thyroid dysfunction at endometrial cancer diagnosis. However, women with evidence of subclinical hypothyroidism had improved survival compared with those who were euthyroid, and those with evidence of hyperthyroidism had worse survival.

This is the first study to explore the impact of clinical and biochemical thyroid dysfunction on endometrial cancer survival outcomes. The authors say more research is now needed to confirm these findings, particularly given their potential therapeutic implications.

Barr CE, Njoku K, Hotchkies L, Ryan NAJ, Wan YL, Davies DA, Razvi S, Crosbie EJ. Does Clinical and Biochemical Thyroid Dysfunction Impact on Endometrial Cancer Survival Outcomes? A Prospective Database Study. Cancers (Basel). 2021 Oct 29;13(21):5444. doi: 10.3390/cancers13215444. PMID: 34771605; PMCID: PMC8582452.


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