DEVELOPMENT OF REMOTE SEQUELAE SUCH AS GASTROINTESTINAL TRACT PATHOLOGY IN PATIENTS SPECIALLY TREATED FOR DIFFERENTIATED THYROID CANCER

Abstract

Objective. Evaluate the potential long-term effects of differentiated thyroid cancer (DTC) treatment, on the gastro-intestinal tract (GIT) based on a retrospective study of DTC patients. Methods. Occurrence of long-term GIT pathologies was retrospectively studied in 157 DTC patients. All patients were treated according to the standard of care, which includes radical surgery, radiation therapy and hormone therapy. The database contained digitalised medical histories of patients followed for at least 1 year after treatment. A total of 463 entries were available, representing one entry per noted consequence for each of the 157 patients. The study focused on two aspects. The frequencies of complications before and after treatment were compared, and factors impacting DTC pathology in a statistically significant manner were isolated. Results: The total onset frequency of gallbladder, liver and pancreas disorders was increased by a factor of 1.6 in a statistically significant manner in DTC patients. Patients initially presenting gallbladder disorders received shorter cures of hormone therapy (4 versus 13 months), and lower levels of L-thyroxine in a context of uncompensated hypothyroidism (2.3 versus 3.5 mg/kg). A statistically significant relation was established between the total duration of breastfeeding in women presenting metabolic health disorders, and onset of liver pathology (essentially non-alcoholic steatohepatitis). Conclusion. Life-long GIT pathology monitoring should be standard of care for patients after special DTC treatment. What this paper adds The long-term effects of treatment of differentiated thyroid cancer on the gastro-intestinal tract have never been described to date. Here, a 1.6-fold increase in disorders implicating mainly the gallbladder, liver and pancreas is noted. Gallbladder disorders are shown to be frequent in patients undergoing short courses of thyroid hormone suppression therapy with low levels of L-thyroxine and presenting uncompensated hypothyroidism. In women presenting metabolic disorders, a relation has been established between the total duration of breastfeeding and the later development of liver pathologies.