Thyroid hormone impairment, represented as an alteration in levels of thyroid hormones and a lower fT3/fT4 ratio, has been correlated with a worse prognosis for both cancer and non-cancer patients. The role of baseline thyroid function in patients with metastatic renal cell carcinoma (mRCC) however, has not been studied yet.
We recorded clinical data, baseline biochemical results, and oncological outcomes from 10 Oncology Units in Italy. We stratified patients into three groups according to the fT3/fT4 ratio value and subsequently analyzed differences in progression-free survival (PFS) and overall survival (OS) in the three groups. We also performed univariate and multivariate analyses to find prognostic factors for PFS and OS.
We analyzed 134 patients treated with systemic treatment for mRCC. Median PFS in the low, intermediate, and high fT3/fT4 ratio group were 7.5, 12.1, and 21.7 months respectively (p<0.001); median OS in the three groups were 36.5, 48.6, and 70.5 months respectively (p =0.006). The low fT3/fT4 ratio maintained its prognostic role at the multivariate analysis independently from IMDC and other well-established prognostic factors. The development of iatrogenic hypothyroidism was not associated with a better outcome.
We found that baseline thyroid hormone impairment, represented by a low fT3/fT4 ratio, is a strong prognostic factor in patients treated for mRCC in first line setting and is independent of other parameters currently used in clinical practice.
Frontiers in oncology. 2021 Nov 25*** epublish ***
Marco Maruzzo, Elena Verzoni, Maria Giuseppa Vitale, Michele Dionese, Sebastiano Buti, Luca Galli, Andrea Zivi, Sara Watutantrige-Fernando, Teresa Zielli, Elisa Zanardi, Roberto Sabbatini, Umberto Basso, Vittorina Zagonel, Giuseppe Procopio
Oncology Unit 1, Istituto Oncologico Veneto, IOV - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padova, Italy., Genito-Urinary (GU) Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Istituto Nazionale dei Tumori, Milano, Italy., Oncology Unit, Azienda Ospedaliera Universitaria di Modena, Modena, Italy., Oncology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy., Oncology Unit, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy., Oncology Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy., Hereditary Tumor Unit, Istituto Oncologico Veneto, IOV - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padova, Italy., Academic Unit of Medical Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Martino Hospital, Genova, Italy.