Oncotarget

Research Papers:

Preoperative low tri-iodothyronine concentration is associated with worse health status and shorter five year survival of primary brain tumor patients

Adomas Bunevicius _, Vytenis Pranas Deltuva, Sarunas Tamasauskas, Timothy Smith, Edward R. Laws, Robertas Bunevicius, Giorgio Iervasi and Arimantas Tamasauskas

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Oncotarget. 2017; 8:8648-8656. https://doi.org/10.18632/oncotarget.14376

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Abstract

Adomas Bunevicius1,2, Vytenis Pranas Deltuva1,2, Sarunas Tamasauskas1, Timothy Smith3, Edward R. Laws3, Robertas Bunevicius4,*, Giorgio Iervasi5, Arimantas Tamasauskas1

1Department of Neurosurgery, Lithuanian University of Health Sciences, Kaunas, Lithuania

2Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania

3Department of Neurosurgery, Brigham and Women’s Hospital, Boston, Massachusetts, USA

4Behavioural medicine institute, Lithuanian University of Health Sciences, Palanga, Lithuania

5CNR Institute of Clinical Physiology, Pisa, Italy

*Dr. R Bunevicius died before the work presented here reached completion. This manuscript is dedicated to his memory and to the many contributions he made to psychoneuroendocrinology.

Correspondence to:

Adomas Bunevicius, email: [email protected]

Keywords: tri-iodothyronine, thyroid, glioma, meningioma, survival

Received: October 04, 2016    Accepted: December 01, 2016    Published: December 30, 2016

ABSTRACT

Background: Low tri-iodothyronine syndrome is associated with worse prognosis of severely ill patients. We investigated the association of thyroid hormone levels with discharge outcomes and 5-year mortality in primary brain tumor patients.

Methods: From January, 2010 until September, 2011, 230 patients (70% women) before brain tumor surgery were evaluated for cognitive (Mini mental State Examination; MMSE) and functional (Barthel index; BI) status, and thyroid function profile. The Low triiodothyronine syndrome was defined as triiodothyronine concentration below the reference range. Unfavorable discharge outcomes were Glasgow outcome scale score of ≤3. Follow-up continued until November, 2015.

Results: Seventy-four percent of patients had Low triiodothyronine syndrome. Lower total tri-iodothyronine concentrations were associated with lower MMSE (p=.013) and BI (p=.023) scores independent of age, gender and histological diagnosis. Preoperative Low tri-iodothyronine syndrome increased risk for unfavorable discharge outcomes adjusting for age, gender and histological diagnosis (OR=2.944, 95%CI [1.314-6.597], p=.009). In all patients, lower tri-iodothyronine concentrations were associated with greater mortality risk (p≤.038) adjusting for age, gender, extent of resection, adjuvant treatment and histological diagnosis. The Low tri-iodothyronine syndrome was associated with greater 5-year mortality for glioma patients (HR=2.197; 95%CI [1.160-4.163], p=.016) and with shorter survival (249 [260] vs. 352 [399] days; p=.029) of high grade glioma patients independent of age, gender, extent of resection and adjuvant treatment.

Conclusions: The Low tri-iodothyronine syndrome is common in brain tumor patients and is associated with poor functional and cognitive status, and with worse discharge outcomes. The Low tri-iodothyronine syndrome is associated with shorter survival of glioma patients.


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