Evidence map›Paper›PMID 41107787›Full record

SynthesisBMC cancer2025

Impact of thyroid dysfunction on clinical outcome in head and neck cancer: a systematic review and meta-analysis.

Sandeepa N C, Tina S Roberts, Johan Frank Opperman, Johan Grobbelaar, Muhammed Ajmal

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Sandeepa N CDept. Diagnostic Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia. sendya@kku.edu.sa.
Tina S RobertsDept. Craniofacial Biology, Oral Pathology & Radiology, Faculty of Dentistry, University of The Western Cape, Bellville, South Africa.
Johan Frank OppermanDept. Craniofacial Biology, Oral Pathology & Radiology, University of the Western Cape, Bellville, South Africa.
Johan GrobbelaarDivision of Otorhinolaryngology, Department of Surgical Sciences, University of Stellenbosch, Stellenbosch, South Africa.
Muhammed AjmalDept. Diagnostic Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe influence of thyroid dysfunction on the clinical outcomes of head and neck cancer (HNC) patients remains an area of ongoing investigation, with previous studies yielding variable results. Treatments for HNC, particularly radiotherapy, frequently impact thyroid function. This meta-analysis aimed to synthesize the available evidence on the association between thyroid status (dysfunction vs. euthyroid) and survival outcomes in HNC patients.

methodsA systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Medline, Web of Science, Cochrane Library, Embase and Scopus were searched (January 2000-October 2024) for studies comparing survival outcomes (primarily Overall Survival) in adult HNC patients with thyroid dysfunction versus euthyroid patients. Two reviewers independently selected studies and extracted relevant data. The risk of bias for included studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies and the Cochrane Risk of Bias 2 (RoB2) tool for randomized controlled trials. Hazard ratios (HRs) with 95% confidence intervals (CIs) comparing survival were pooled using both fixed-effect (common-effect) and random-effects (REML) models. Heterogeneity across studies was assessed using the I² statistic and Cochran's Q test. Statistical analyses were performed using R with the meta package.

resultsSix studies met the inclusion criteria for systematic review. Four of these studies, encompassing 671 participants, reported sufficient data (Hazard Ratios for Overall Survival) for meta-analysis. The fixed-effect model yielded a pooled HR of 0.99 (95% CI: 0.98, 1.00; p = 0.0013). However, significant heterogeneity was observed (I² = 81.5%, p = 0.0010). Consequently, the random-effects model, deemed more appropriate, yielded a pooled HR of 1.45 (95% CI: 0.66, 3.19; p = 0.3601), indicating no statistically significant association between thyroid status and overall survival in HNC patients. The estimated between-study variance (τ²) was 0.53.

conclusionThis meta-analysis revealed substantial heterogeneity among studies investigating the impact of thyroid status on HNC survival. When accounting for this heterogeneity using a random-effects model, no significant association was found. The findings highlight the need for further research with larger sample sizes, standardized definitions of thyroid dysfunction, consistent reporting of adjusted effect estimates, and exploration of heterogeneity sources.

trial registrationCRD42024535167.

Indexed as

Head and Neck NeoplasmsThyroid DiseasesThyroid GlandHumansTreatment OutcomeDisease-free survivalHead and neck cancerOverall survivalProgression- free survivalThyroid dysfunction

Identifiers

PMID41107787
PMCPMC12535142

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.