ArticleThe oncologist2021
An Underdiagnosed Hypothyroidism and Its Clinical Significance in Patients with Advanced Hepatocellular Carcinoma.
Article in The oncologist, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 14 citations in OpenAlex.
- Risk and prognosis of HCC in patients with thyroid disease: A nationwide cohort study.Hepatology communications · 2025Article
- Transarterial chemoembolization combined with tyrosine kinase inhibitors and/or immune checkpoint inhibitors induced hypothyroidism is associated with improved overall survival in hepatocellular carcinoma.Cancer immunology, immunotherapy : CII · 2025Article
- Thyroid hormone, immunoglobin and complements for predicting hepatocellular carcinoma development in patients with hepatitis B virus-related liver cirrhosis.World journal of hepatology · 2025Article
- Tislelizumab plus lenvatinib for hepatocellular carcinoma with hypothyroidism. A case report and literature review.Frontiers in immunology · 2025Review
- Real-world experience of lenvatinib-based therapy in patients with advanced hepatocellular carcinoma.Journal of gastrointestinal oncology · 2024Article
- Tyrosine kinase inhibitor-induced hypothyroidism: mechanism and clinical implications.European journal of clinical pharmacology · 2024Review
- Changes in Posttreatment Spleen Volume Associated with Immunotherapy Outcomes for Advanced Hepatocellular Carcinoma.Journal of hepatocellular carcinoma · 2024Article
- Protective effect of higher free thyroxine levels within the reference range on biliary tract cancer risk: a multivariable mendelian randomization and mediation analysis.Frontiers in endocrinology · 2024Article
- Potential use of TG68 - A novel thyromimetic - for the treatment of non-alcoholic fatty liver (NAFLD)-associated hepatocarcinogenesis.Frontiers in oncology · 2023Article
- Dynamic follow-up of the effects of programmed death 1 inhibitor treatment on thyroid function and sonographic features in patients with hepatocellular carcinoma.Endocrine connections · 2022Article
- Hypothyroidism has a protective causal association with hepatocellular carcinoma: A two-sample Mendelian randomization study.Frontiers in endocrinology · 2022Article
- mRNA-miRNA networks identify metabolic pathways associated to the anti-tumorigenic effect of thyroid hormone on preneoplastic nodules and hepatocellular carcinoma.Frontiers in oncology · 2022Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany systemic therapies for advanced hepatocellular carcinoma (HCC) may cause hypothyroidism; however, in these patients, hypothyroidism prevalence before therapy and its prognostic impact remain unclear. MATERIALS AND
methodsWe previously established a prospective cohort of patients who received sorafenib as first-line therapy for advanced HCC. No patients had been clinically diagnosed with hypothyroidism before or during sorafenib treatment. We retrospectively determined the levels of thyrotropin and free thyroxine before initiation of systemic therapy. Hypothyroidism was defined as thyrotropin level higher than the upper limit of the normal range. Among patients with hypothyroidism, free thyroxine level less than the lower normal range was defined as overt hypothyroidism, and free thyroxine level within the normal range was defined as subclinical hypothyroidism.
resultsIn total, 79 patients were enrolled; of them, 16 (20%) had hypothyroidism (overt hypothyroidism, 10; subclinical hypothyroidism, 6). Patients with hypothyroidism, compared with those without hypothyroidism, were more likely to be older than 65 years (56% vs. 29%, p = .037), have a serum α-fetoprotein level of >400 ng/mL (81% vs. 52%, p = .037), and have a significantly poorer overall survival (OS; median, 5.5 vs. 11.6 months, p = .043). After adjusting for other potential prognostic factors, hypothyroidism remained an independent predictor for poorer OS (hazard ratio, 2.53, p = .018). Patients with overt hypothyroidism and subclinical hypothyroidism exhibited similarly poor OS (p = .768).
conclusionUnderdiagnosis of hypothyroidism in patients with advanced HCC was common. Hypothyroidism, whether overt or subclinical, is associated with poor prognosis of advanced HCC. IMPLICATIONS FOR PRACTICE: The results of this study showed the underdiagnosis of hypothyroidism in patients with advanced hepatocellular carcinoma (HCC) and its influence on prognosis. These findings implied the importance of thyroid function check before initiation of systemic therapy for patients with advanced HCC.
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