Background: This work endeavored to explore the effect of hypothyroidism on mortality in subjects with HCC who underwent living-donor liver transplantation (LDLT).
Methods: This prospective study included 107 patients with HCC subjected to LDLT, divided into hypothyroid group (n=53) and euthyroid group (n=54). The primary objectives were overall and disease-free survival (DFS).
Results: Euthyroid and hypothyroid groups were comparable in all baseline characteristics except the age of patients. Overall survival (OS) of the whole group at 48 months was 68.8%, while the DFS was 60.2%. On univariate analysis, OS was negatively affected by the older age of the patients (p< 0.001) or the donor (p< 0.001), hypothyroidism (p=0.008), HBV (p=0.029), larger tumor size (p=0.023), and defective Milan criteria (p=0.022). On multivariate analysis, the age of the patients and donors was the independent factor affecting OS. On univariate analysis, DFS was negatively affected by older age of the patients (p < 0.001) or the donor (p=0.005), hypothyroidism (p=0.005), HBV (p=0.019), larger tumor size (p=0.023), and defective Milan criteria (p=0.020). On multivariate analysis, the age of the patients, thyroid status, and Milan criteria were the independent factors affecting DFS.
Conclusion: Hypothyroidism is a risk factor for worse outcomes in HCC patients after liver transplantation.



中文翻译：

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甲状腺功能减退对接受肝移植的肝细胞癌患者的影响

背景：本研究旨在探讨甲状腺功能减退对接受活体肝移植 (LDLT) 的 HCC 患者死亡率的影响。
方法：本前瞻性研究纳入 107 例接受 LDLT 的 HCC 患者，分为甲状腺功能减退组（n=53）和甲状腺功能正常组（n=54）。主要目标是总体和无病生存（DFS）。
结果：除患者年龄外，甲状腺功能正常组和甲状腺功能减退组在所有基线特征上均具有可比性。全组48个月总生存率（OS）为68.8%，DFS为60.2%。在单变量分析中，OS 受患者年龄 (p<0.001) 或供体 (p<0.001)、甲状腺功能减退 (p=0.008)、HBV (p=0.029)、肿瘤大小 (p=0.023) 的负面影响) 和有缺陷的米兰标准 (p=0.022)。在多因素分析中，患者和供者的年龄是影响 OS 的独立因素。在单变量分析中，DFS 受患者年龄较大 (p < 0.001) 或供体 (p=0.005)、甲状腺功能减退 (p=0.005)、HBV (p=0.019)、肿瘤大小 (p=0.023) 的负面影响和有缺陷的米兰标准 (p=0.020)。在多变量分析中，患者的年龄、甲状腺状况、
结论：甲状腺功能减退是肝移植后 HCC 患者预后较差的危险因素。