Surgery Today

, Volume 47, Issue 4, pp 506–512 | Cite as

Is body mass index relevant to prognosis of papillary thyroid carcinoma? A clinicopathological cohort study

Original Article
  • 173 Downloads

Abstract

Purpose

Obesity appears to be related to papillary thyroid carcinoma (PTC) in the observational studies, although its relationship concerning the PTC prognosis has not been established. We investigated the association between body mass index (BMI) and the prognosis of PTC.

Methods

The WHO BMI classification was used to stratify the degree of obesity. The final outcome was disease status, including recurrence and persistence, of 783 PTC patients. We reviewed patients’ BMI, disease status, and other prognostic factors retrospectively.

Results

The mean BMI was 24.2 kg/m2. When stratified according to the WHO BMI classification, 21 were Underweight, 482 were Normal, 232 were Overweight, and 48 were Obese. We divided patients into two groups: <25.0 kg/m2 (n = 503) vs. ≥25.0 kg/m2 (n = 280). The BMI ≥25.0 group was older and more likely to be male in a multivariate analysis (p < 0.001). For those with BMI <25.0 and ≥25.0, recurrence occurred in 3.0 and 2.1 % (p = 0.486), persistence in 7.2 and 5.1 % (p = 0.265), and either recurrence or persistence in 9.9 and 7.1 %, respectively (p = 0.189). A multivariate analysis revealed that older age and male gender in Overweight vs. Normal, older age in Obese vs. Normal, and advanced T stage in Normal vs. Underweight were statistically significant prognostic factors.

Conclusions

There was no significant difference in the prognosis according to BMI in PTC patients. However, old age, male gender, and advanced T-stage patients were found more frequently in the higher BMI group than in the lower BMI group.

Keywords

Papillary thyroid carcinoma Obesity BMI Prognosis 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest in association with this study.

References

  1. 1.
    Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA. 2006;295:2164–7.CrossRefPubMedGoogle Scholar
  2. 2.
    Davies L, Ouellette M, Hunter M, Welch HG. The increasing incidence of small thyroid cancers: where are the cases coming from? Laryngoscope. 2010;120:2446–51.CrossRefPubMedGoogle Scholar
  3. 3.
    Oh CM, Jung KW, Won YJ, Shin A, Kong HJ, Lee JS. Age-period-cohort analysis of thyroid cancer incidence in Korea. Cancer Res Treat. 2015;47:362–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Enewold L, Zhu K, Ron E, Marrogi AJ, Stojadinovic A, Peoples GE, et al. Rising thyroid cancer incidence in the United States by demographic and tumor characteristics, 1980–2005. Cancer Epidemiol Biomark Prev. 2009;18:784–91.CrossRefGoogle Scholar
  5. 5.
    Pazaitou-Panayiotou K, Polyzos SA, Mantzoros CS. Obesity and thyroid cancer: epidemiologic associations and underlying mechanisms. Obes Rev. 2013;14:1006–22.CrossRefPubMedGoogle Scholar
  6. 6.
    Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348:1625–38.CrossRefPubMedGoogle Scholar
  7. 7.
    Reeves GK, Pirie K, Beral V, Green J, Spencer E, Bull D, Million Women Study Collaboration. Cancer incidence and mortality in relation to body mass index in the Million Women Study: cohort study. BMJ. 2007;335:1134.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    De Pergola G, Silvestris F. Obesity as a major risk factor for cancer. J Obes. 2013;291546.Google Scholar
  9. 9.
    Kitahara CM, Platz EA, Freeman LE, Hsing AW, Linet MS, Park Y, et al. Obesity and thyroid cancer risk among U.S. men and women: a pooled analysis of five prospective studies. Cancer Epidemiol Biomark Prev. 2011;20:464–72.CrossRefGoogle Scholar
  10. 10.
    Rinaldi S, Lise M, Clavel-Chapelon F, Boutron-Ruault MC, Guillas G, Overvad K, et al. Body size and risk of differentiated thyroid carcinomas: findings from the EPIC study. Int J Cancer. 2012;131:E1004–14.CrossRefPubMedGoogle Scholar
  11. 11.
    Xu L, Port M, Landi S, Gemignani F, Cipollini M, Elisei R, et al. Obesity and the risk of papillary thyroid cancer: a pooled analysis of three case–control studies. Thyroid. 2014;24:966–74.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Pappa T, Alevizaki M. Obesity and thyroid cancer: a clinical update. Thyroid. 2014;24:190–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Marcello MA, Cunha LL, Batista FA, Ward LS. Obesity and thyroid cancer. Endocr Relat Cancer. 2014;21:T255–71.CrossRefPubMedGoogle Scholar
  14. 14.
    Trésallet C, Seman M, Tissier F, Buffet C, Lupinacci RM, Vuarnesson H, et al. The incidence of papillary thyroid carcinoma and outcomes in operative patients according to their body mass indices. Surgery. 2014;156:1145–52.CrossRefPubMedGoogle Scholar
  15. 15.
    Harari A, Endo B, Nishimoto S, Ituarte PH, Yeh MW. Risk of advanced papillary thyroid cancer in obese patients. Arch Surg. 2012;147:805–11.CrossRefPubMedGoogle Scholar
  16. 16.
    Kim HJ, Kim NK, Choi JH, Sohn SY, Kim SW, Jin SM, et al. Associations between body mass index and clinico-pathological characteristics of papillary thyroid cancer. Clin Endocrinol (Oxf). 2013;78:134–40.CrossRefPubMedGoogle Scholar
  17. 17.
    Dieringer P, Klass EM, Caine B, Smith-Gagen J. Associations between body mass and papillary thyroid cancer stage and tumor size: a population-based study. J Cancer Res Clin Oncol. 2015;141:93–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Na AS, Kang SY, Kim SK, Youn HJ, Jung SH. Clinicopathological relevance between body mass index and papillary thyroid carcinoma. Korean J Endocr Surg. 2014;14:171–6.CrossRefGoogle Scholar
  19. 19.
    Kim SH, Park HS, Kim KH, Yoo H, Chae BJ, Bae JS, et al. Correlation between obesity and clinicopathological factors in patients with papillary thyroid cancer. Surg Today. 2015;45:723–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Kim JY, Jung EJ, Jeong SH, Jeong CY, Ju YT, Lee YJ, et al. The indices of body size and aggressiveness of papillary thyroid carcinoma. J Korean Surg Soc. 2011;80:241–4.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Paes JE, Hua K, Nagy R, Kloos RT, Jarjoura D, Ringel MD. The relationship between body mass index and thyroid cancer pathology features and outcomes: a clinicopathological cohort study. J Clin Endocrinol Metab. 2010;95:4244–50.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Japan 2016

Authors and Affiliations

  • Yoo Seung Chung
    • 1
  • Joon-Hyop Lee
    • 1
  • Young Don Lee
    • 1
  1. 1.Thyroid and Endocrine Surgery Section, Department of Surgery, Gachon University Gil Medical Center, Gachon University School of MedicineGachon UniversityIncheonRepublic of Korea

Personalised recommendations