The prevalence of hypothyroidism after treatment for laryngeal and hypopharyngeal carcinomas: are autoantibodies of influence?
CONCLUSIONS
The incidence rate of hypothyroidism after treatment for laryngeal and hypopharyngeal cancer is high, especially after combination treatment. An association between hypothyroidism and autoantibodies was found.


OBJECTIVE
The incidences of hypothyroidism and autoantibodies were assessed retrospectively in 156 patients with laryngeal and hypopharyngeal carcinoma who were treated with surgery and/or radiotherapy between 1977 and 2002.


METHODS
Patients treated for T2-T4 carcinoma or a recurrence after T1 who visited the outpatient clinic for their regular follow-up visit were included. All patients were evaluated for the development of hypothyroidism, defined as increased thyroid-stimulating hormone level (>4.5 mU/L) and the presence of autoantibodies. A questionnaire regarding symptoms was administered.


RESULTS
The prevalence of undiagnosed hypothyroidism following treatment of laryngeal carcinoma was 28.2%: 18.6% subclinical hypothyroidism and 9.6% clinical hypothyroidism. The prevalence of circulating antithyroid antibodies (anti-thyreoperoxidase and/or anti-thyreoglobulin) was 10.5%. Univariate analysis showed that patients with laryngectomy, hemithyroidectomy, ipsilateral neck dissection and autoantibodies had a higher risk of hypothyroidism. The combination of surgery and radiotherapy increased the risk. Symptoms such as weight gain and cold intolerance were significantly associated with hypothyroidism. Multivariate analysis showed hemithyroidectomy, autoantibodies, weight gain and cold intolerance to be prognostic factors for the development of hypothyroidism.
Lo Galbo
Annalisa M
AM
Department of Otorinolaryngology/Head and Neck Surgery, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
de Bree
Remco
R
Kuik
Dirk J
DJ
Lips
Paul Th A M
PT
Mary
B
B
Von Blomberg
E
E
Langendijk
Johannes A
JA
Leemans
C Rene
CR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D007037:Hypothyroidism / Q000453:epidemiology / Q000209:etiology*; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D008297:Male; D008562:Membrane Glycoproteins / Q000276:immunology; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011379:Prognosis; D062085:RNA, Long Noncoding; D018714:Radiotherapy, Adjuvant; D012307:Risk Factors; D013954:Thyroglobulin / Q000276:immunology; D013965:Thyroidectomy; D013972:Thyrotropin / Q000097:blood
D001323:Autoantibodies; C509980:LINC00273 lncRNA, human; D008562:Membrane Glycoproteins; D062085:RNA, Long Noncoding; D013972:Thyrotropin; D013954:Thyroglobulin