Preoperative low tri-iodothyronine concentration is associated with worse health status and shorter five year survival of primary brain tumor patients

• Published in: Oncotarget 2017-01, Vol.8 (5), p.8648-8656
• Main Authors: Bunevicius, Adomas, Deltuva, Vytenis Pranas, Tamasauskas, Sarunas, Smith, Timothy, Laws, Edward R, Bunevicius, Robertas, Iervasi, Giorgio, Tamasauskas, Arimantas
• Format: Article
• Language: English
• Subjects: Adult; Aged; Brain Neoplasms - blood; Brain Neoplasms - diagnosis; Brain Neoplasms - mortality; Brain Neoplasms - surgery; Chi-Square Distribution; Cognition; Down-Regulation; Female; Health Status; Humans; Kaplan-Meier Estimate; Male; Mental Status and Dementia Tests; Middle Aged; Multivariate Analysis; Odds Ratio; Predictive Value of Tests; Proportional Hazards Models; Research Paper; Risk Factors; Thyroid Function Tests; Thyroid Gland - metabolism; Thyroid Gland - physiopathology; Time Factors; Treatment Outcome; Triiodothyronine - blood
• ISSN: 1949-2553; 1949-2553
• DOI: 10.18632/oncotarget.14376

Low tri-iodothyronine syndrome is associated with worse prognosis of severely ill patients. We investigated the association of thyroid hormone levels with discharge outcomes and 5-year mortality in primary brain tumor patients. From January, 2010 until September, 2011, 230 patients (70% women) before brain tumor surgery were evaluated for cognitive (Mini mental State Examination; MMSE) and functional (Barthel index; BI) status, and thyroid function profile. The Low triiodothyronine syndrome was defined as triiodothyronine concentration below the reference range. Unfavorable discharge outcomes were Glasgow outcome scale score of ≤3. Follow-up continued until November, 2015. Seventy-four percent of patients had Low triiodothyronine syndrome. Lower total tri-iodothyronine concentrations were associated with lower MMSE (p=.013) and BI (p=.023) scores independent of age, gender and histological diagnosis. Preoperative Low tri-iodothyronine syndrome increased risk for unfavorable discharge outcomes adjusting for age, gender and histological diagnosis (OR=2.944, 95%CI [1.314-6.597], p=.009). In all patients, lower tri-iodothyronine concentrations were associated with greater mortality risk (p≤.038) adjusting for age, gender, extent of resection, adjuvant treatment and histological diagnosis. The Low tri-iodothyronine syndrome was associated with greater 5-year mortality for glioma patients (HR=2.197; 95%CI [1.160-4.163], p=.016) and with shorter survival (249 [260] vs. 352 [399] days; p=.029) of high grade glioma patients independent of age, gender, extent of resection and adjuvant treatment. The Low tri-iodothyronine syndrome is common in brain tumor patients and is associated with poor functional and cognitive status, and with worse discharge outcomes. The Low tri-iodothyronine syndrome is associated with shorter survival of glioma patients.