Impact of body mass index on survival outcome in patients with differentiated thyroid cancer

Al-Ammar, Yousif; Al-Mansour, Bader; Al-Rashood, Omar; Tunio, Mutahir A.; Islam, Tahera; AlAsiri, Mushabbab; Al‐Qahtani, Khalid

doi:10.1016/j.bjorl.2017.02.002

Cited by 9 publications

(7 citation statements)

References 20 publications

(32 reference statements)

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“…We investigated the relationship between BMI and the survival of DTC patients and found that there was no significant difference in the overall survival of patients in relation to BMI groups. These results are in line with those of Yousif Al-Ammar et al [ 59 ].…”

Section: Discussionsupporting

confidence: 93%

The impact of BMI on clinical progress, response to treatment, and disease course in patients with differentiated thyroid cancer

Gąsior-Perczak¹,

Pałyga²,

Szymonek³

et al. 2018

PLoS ONE

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IntroductionObesity is a serious health problem worldwide, particularly in developed countries. It is a risk factor for many diseases, including thyroid cancer. The relationship between obesity and prognostic factors of thyroid cancer is unclear.AimsWe sought to ascertain the relationship between body mass index (BMI) and clinicopathological features increasing the risk of poor clinical course, treatment response, and clinical outcome in patients with differentiated thyroid cancer (DTC).Subjects & methodsThe study included 1181 patients with DTC (88% women and 12% men) treated at a single center from 2000 to 2016. BMI before surgery and aggressive clinicopathological features, according to the American Thyroid Initial Risk stratification system, were analyzed. The relationship between BMI and initial risk, treatment response, and final status of the disease was evaluated, incorporating the revised 2015 American Thyroid Association guidelines and the 8th edition of the American Joint Committee on Cancer/Tumor-Node-Metastasis (AJCC/TNM) staging system. Patients were stratified according to the World Health Organization classification of BMI. Statistical analysis was performed using univariate and multivariate logistic regression analysis.ResultsMedian follow-up was 7.7 years (1–16 years). There were no significant associations between BMI and extrathyroidal extension (microscopic and gross), cervical lymph node metastasis, or distant metastasis in univariate and multivariate analyses. BMI did not affect initial risk, treatment response or disease outcome. Obesity was more prevalent in men (p = 0.035) and in patients ≥55 years old (p = 0.001). There was no statistically significant relationship between BMI and more advanced TNM stage in patients ≤55 years old (stage I vs. stage II) (p = 0.266) or in patients >55 years old (stage I–II vs. III–IV) (p = 0.877).ConclusionsObesity is not associated with more aggressive clinicopathological features of thyroid cancer. Obesity is not a risk factor for progression to more advanced stages of disease, nor is it a prognostic factor for poorer treatment response and clinical outcome.

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Section: Discussionsupporting

confidence: 93%

The impact of BMI on clinical progress, response to treatment, and disease course in patients with differentiated thyroid cancer

Gąsior-Perczak¹,

Pałyga²,

Szymonek³

et al. 2018

PLoS ONE

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“…Although this sample only represents a small subset of all thyroid cancers in Ecuador, histological characteristics and method of diagnosis are similar to the ones described in other reports [28][29][30][31][32][33] . We did not see an increased frequency of aggressive thyroid cancer histological findings that might explain the increase in thyroid cancer mortality in Ecuador.…”

Section: Discussionsupporting

confidence: 58%

Incidental diagnosis and surgery outcomes of thyroid cancer in Ecuador

Solís-Pazmiño¹,

Salazar-Vega²,

Lincango-Naranjo³

et al. 2019

Preprint

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Background: In contrast to the rapid increase in thyroid cancer (TC) incidence, thyroid cancer mortality rates have remained low and stable over the last decades. In Ecuador, however, TC mortality has increased and to determine possible drivers, a retrospective analysis of all patients attending a thyroid cancer referral center in Ecuador was conducted. Methods: From June 2014 to December 2017, a cross-sectional study was conducted at the Hospital de Especialidades Eugenio Espejo (HEEE), a regional reference public hospital for endocrine neoplasia in adults in Quito, Ecuador. We identified the mechanism of detection, histopathology and treatment modalities from a patient interview and review of clinical records. Results: Among 452 patients, 74.8% were young adults and 94.2% (426) of patients were female. 13.7% had a family history of thyroid cancer, and median of tumor size was 2 cm. The incidental finding was 54.2% whereas 45.8% was non-incidental. Thyroid cancer histology reported that 93.3% had papillary thyroid cancer (PTC), 2.7% follicular, 1.5% Hurtle cells, 1.6% medullary, 0.7% poor differentiated, and 0.2% anaplastic carcinoma. The mean MACIS (metastasis, age, completeness, invasion, and size) score was 4.95 (CI 4.15-5.95) with 76.2% of the thyroid cancer patients having MACIS score equal or less than 6. The very low and low risk of recurrence was 18.1% (79) and 62% (271) respectively. An analysis of 319 patients with non-metastatic thyroid cancer showed that 10.7% (34) of patients had surgical complications. Moreover, around 62.5% (80 from 128 patients with thyroglobulin laboratory results) of TC patients had a stimulated-thyroglobulin (sTg) value equal or higher than 2 ng/ml. Overall, a poor surgical outcome was present in 35.1% (112) patients. Out of 436 patients with differentiated thyroid carcinoma (DTC), 86% (n=375) received radioactive iodine (RAI). Conclusion: Thyroid cancer histological characteristics and method of diagnosis are like the ones described in other reports without any evidence of the high frequency of aggressive thyroid cancer histology. However, we observed evidence of overtreatment and poor surgical outcomes that demand additional studies to understand their association with thyroid cancer mortality in Ecuador.

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“…Although this sample only represents a small subset of all thyroid cancers in Ecuador, histological characteristics and methods of diagnosis are similar to the ones described in other reports [26][27][28][29][30][31] . We did not see an increased frequency of aggressive thyroid cancer histological ndings that might explain the increase in thyroid cancer mortality in Ecuador.…”

Section: Discussionmentioning

confidence: 56%

Thyroid Cancer Overdiagnosis and Overtreatment: a cross- sectional study at a thyroid cancer referral center in Ecuador 

Solís-Pazmiño¹,

Salazar-Vega

Lincango-Naranjo

et al. 2020

Preprint

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Background: In contrast to the rapid increase in thyroid cancer (TC) incidence, thyroid cancer mortality has remained low and stable over the last decades. In Ecuador, however, TC mortality has increased. The objective of this study is to determine possible drivers of high rates of thyroid cancer mortality, through a cross-sectional analysis of all patients attending a thyroid cancer referral center in Ecuador.Methods: From June 2014 to December 2017, a cross-sectional study was conducted at the Hospital de Especialidades Eugenio Espejo (HEEE), a regional reference public hospital for endocrine neoplasia in adults in Quito, Ecuador. We identified the mechanism of detection, histopathology and treatment modalities from a patient interview and review of clinical records. Results: Among 452 patients, 74.8% were young adults and 94.2% (426) were female. 13.7% had a family history of thyroid cancer, and patients’ median tumor size was 2 cm. The incidental finding was 54.2% whereas 45.8% was non-incidental. Thyroid cancer histology reported that 93.3% had papillary thyroid cancer (PTC), 2.7% follicular, 1.5% Hurtle cells, 1.6% medullary, 0.7% poor differentiated, and 0.2% anaplastic carcinoma. The mean MACIS (metastasis, age, completeness, invasion, and size) score was 4.95 (CI 4.15-5.95) with 76.2% of the thyroid cancer patients having MACIS score less than or equal to 6. The very low and low risk of recurrence was 18.1% (79) and 62% (271) respectively. An analysis of 319 patients with non-metastatic thyroid cancer showed that 10.7% (34) of patients had surgical complications. Moreover, around 62.5% (80 from 128 patients with thyroglobulin laboratory results) of TC patients had a stimulated-thyroglobulin (sTg) value equal or higher than 2 ng/ml. Overall, a poor surgical outcome was present in 35.1% (112) patients. Out of 436 patients with differentiated thyroid carcinoma (DTC), 86% (375) received radioactive iodine (RAI). Conclusion: Thyroid cancer histological characteristics and method of diagnosis are like those described in other reports without any evidence of the high frequency of aggressive thyroid cancer histology. However, we observed evidence of overtreatment and poor surgical outcomes that demand additional studies to understand their association with thyroid cancer mortality in Ecuador.

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Impact of body mass index on survival outcome in patients with differentiated thyroid cancer

Abstract: Although body mass index can increase the risk of thyroid cancer, it has no impact on treatment outcome; however, further trials are warranted.

Cited by 9 publications

References 20 publications

The impact of BMI on clinical progress, response to treatment, and disease course in patients with differentiated thyroid cancer

The impact of BMI on clinical progress, response to treatment, and disease course in patients with differentiated thyroid cancer

Incidental diagnosis and surgery outcomes of thyroid cancer in Ecuador

Thyroid Cancer Overdiagnosis and Overtreatment: a cross- sectional study at a thyroid cancer referral center in Ecuador

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Impact of body mass index on survival outcome in patients with differentiated thyroid cancer

Abstract: Although body mass index can increase the risk of thyroid cancer, it has no impact on treatment outcome; however, further trials are warranted.

Cited by 9 publications

References 20 publications

The impact of BMI on clinical progress, response to treatment, and disease course in patients with differentiated thyroid cancer

The impact of BMI on clinical progress, response to treatment, and disease course in patients with differentiated thyroid cancer

Incidental diagnosis and surgery outcomes of thyroid cancer in Ecuador

Thyroid Cancer Overdiagnosis and Overtreatment: a cross- sectional study at a thyroid cancer referral center in Ecuador&nbsp;

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Thyroid Cancer Overdiagnosis and Overtreatment: a cross- sectional study at a thyroid cancer referral center in Ecuador