Dataset Information

Subsequent thyroid disorders associated with treatment strategy in head and neck cancer patients: a nationwide cohort study.

ABSTRACT:

Background

We investigated the risk of thyroid disorders, namely hypothyroidism, thyrotoxicosis and thyroiditis, in head and neck cancer patients undergoing multimodal treatment.

Methods

A cohort study design using Taiwan's National Health Insurance Research Database was used to assess head and neck cancer patients over 20?years old. The cohort was divided into one group who underwent primary tumor excision only (PTE) and another with additional neck dissection (PTE?+?ND). The tumor sites were stratified to estimate the tumor-site-specific risk of thyroid disorders. The effect of subsequent resurgery, radiotherapy (RT), chemotherapy (CT), and concomitant (CCRT) or sequential chemoradiation therapy (sequential CT+ RT) on the risk of thyroid disorders was explored.

Results

For 1999-2012, 7460 patients who underwent PTE?+?ND and 3730 who underwent PTE were enrolled and followed-up until the end of 2013. There were 122 and 50 patients in the two groups, respectively, who developed thyroid disorders, with no statistical difference between the groups. Patients with hypopharyngeal, oropharyngeal, or laryngeal cancer in the PTE?+?ND group had a higher risk of thyroid disorders (adjusted HR: 1.50, 95% CI: 0.67-3.38) than those in the PTE group when adjusted for covariates and mortality. Patients who underwent subsequent RT (adjusted HR: 3.64, 95% CI: 1.05-2.77) and CCRT (adjusted HR: 1.70, 95% CI: 1.05-2.77) after PTE?+?ND had a significantly higher risk of thyroid disorders.

Conclusion

RT results in a major risk of subsequent thyroid disorders, and ND may exacerbate this effect. Physicians should monitor thyroid function from two years after treatment initiation, especially in patients who undergo ND and subsequent RT.

SUBMITTER: Lin CL

PROVIDER: S-EPMC6524259 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Subsequent thyroid disorders associated with treatment strategy in head and neck cancer patients: a nationwide cohort study.

Lin Chien-Liang CL Wu Shang-Yin SY Huang Wen-Tsung WT Feng Yin-Hsun YH Yiu Ching-Yi CY Chiang Wei-Fan WF Ho Sheng-Yow SY Lin Sheng-Hsiang SH

BMC cancer 20190516 1

<h4>Background</h4>We investigated the risk of thyroid disorders, namely hypothyroidism, thyrotoxicosis and thyroiditis, in head and neck cancer patients undergoing multimodal treatment.<h4>Methods</h4>A cohort study design using Taiwan's National Health Insurance Research Database was used to assess head and neck cancer patients over 20 years old. The cohort was divided into one group who underwent primary tumor excision only (PTE) and another with additional neck dissection (PTE + ND). The tum ...[more]

PMID: 31096939

Similar Datasets

Project description:Simple Summary The standard treatment for well-differentiated thyroid cancer is thyroidectomy followed by radioactive iodine (RAI) treatment or active surveillance. Despite adequate documentation of acute gastrointestinal adverse effects after RAI treatment, whether the gastrointestinal exposure causes long-term comorbidity or not remained unclear. We conducted a nationwide, population-based retrospective cohort study using the data from the Taiwan National Health Insurance Research Database (NHIRD) to clarify the association between long-term gastrointestinal disorders (including ulcers, atrophic gastritis, and secondary stomach malignancy) and RAI treatment in thyroid cancer patients. We found that patients with RAI treatment were at a significantly higher risk of developing gastric and duodenal ulcers than those without. In addition, a higher cumulative dose is associated with higher risk. Therefore, follow-ups at gastrointestinal clinics might be of great importance for patients presenting with chronic gastrointestinal discomforts, after receiving a single RAI dose of more than 1.11 GBq, and undergoing repeated treatment due to recurrent or residual thyroid cancer. Abstract (1) Background: The study aimed to investigate the association between radioactive iodine (RAI) treatment and long-term gastrointestinal disorders including ulcers, atrophic gastritis, and secondary malignant neoplasm of the stomach in patients with thyroid cancer. (2) Methods: The data of the study were extracted from the National Health Insurance Database (NHIRD) of Taiwan between 2000 to 2015. Patients of ages older than 20 with thyroid cancer after thyroidectomy were included and divided into groups with RAI (study cohort) and without RAI (comparison cohort). Multivariate Cox proportional hazards regression analysis and the Kaplan–Meier method were used for statistical analysis. (3) Results: A total of 7250 (with RAI: 5800, without RAI: 1450) patients were included. The Kaplan-Meier analysis revealed a significantly higher cumulative risk for overall gastrointestinal disorders in the group with RAI (log-rank p = 0.034). The risk for gastrointestinal disorders was higher when receiving a cumulative RAI dose higher than 1.11 GBq in the Cox regression analysis. In the subgroup analysis, the risks of gastric and duodenal ulcers are significantly higher in the group with RAI treatment. (4) Conclusions: This study revealed that RAI was associated with an increased risk for long-term gastrointestinal disorders, specifically gastric and duodenal ulcers, in thyroid cancer, especially when the cumulative dose exceeds 1.11 GBq.

Dataset Information

Subsequent thyroid disorders associated with treatment strategy in head and neck cancer patients: a nationwide cohort study.

Background

Methods

Results

Conclusion

Publications

Subsequent thyroid disorders associated with treatment strategy in head and neck cancer patients: a nationwide cohort study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets