Obesity Does Not Modify the Risk of Differentiated Thyroid Cancer in a Cytological Series of Thyroid Nodules

Rotondi, Mario; Castagna, Maria Grazia; Cappelli, Carlo; Ciuoli, Cristina; Coperchini, Francesca; Chiofalo, Francesco; Maino, Fabio; Palmitesta, Paola; Chiovato, Luca; Pacini, Furio

doi:10.1159/000445054

Cited by 25 publications

(11 citation statements)

References 37 publications

(98 reference statements)

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“…Their results showed that higher BMI correlated with lower rates of thyroid malignancy except women older than 45 years in whom a positive association was found. An Italian study [23] reported that obesity did not modify the risk of differentiated thyroid cancer in patients underwent FNAB. A French study [24] recruited 6684 consecutive postoperative patients, and suggested that overweight and obese patients were not at greater risk of thyroid cancer, whereas they argued that BMI was risk factor for postoperative locoregional events in the macro-PTC patients.…”

Section: Discussionmentioning

confidence: 97%

Association of obesity with the clinicopathological features of thyroid cancer in a large, operative population

Zhao¹,

Jia²,

Fan³

et al. 2019

Medicine

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We aimed to investigate the association between excess body mass index (BMI) and papillary thyroid cancer (PTC) in an operative population, and the impact of higher BMI on clinicopathological aggressiveness of PTC.Charts of 10,844 consecutive patients with thyroid nodules undergoing partial or total thyroidectomy between 1993 and 2015 were reviewed. Patients diagnosed with PTC were stratified in 4 groups: BMI < 18.5 (underweight), 18.5 BMI < 24 (normal-weight), 24 BMI < 28 (overweight) and BMI ≥ 28(obese). The impacts of high BMI on prevalence and clinicopathological parameters of PTC were retrospectively analyzed in both univariate and multivariate binary logistic regression analysis.For every 5-unit increase in body mass, the odds of risk-adjusted malignance increased by 36.6%. The individuals who were obese and overweight were associated with high risk of thyroid cancer [odds ratio (OR)= 1.982, P < .001; OR= 1.377, P < .001; respectively] compared to normal weight patients, and this positive association was found in both genders. Obesity was independent predictors for tumors larger than 1 cm (OR = 1.562, P < .001) and multifocality (OR = 1.616, P < .001). However, there was no difference in cervical lymph node (LN) metastasis among BMI groups. Crude analysis showed BMI was associated with advanced tumor-node-metastasis (TNM) stage (relative risk, approximately 1.23 per 5 BMI units, P < .001), but this association disappeared after adjusting for confounding factors.Obesity was significantly associated with the risk of PTC in a large, operative population. Higher BMI was significantly associated with larger tumor size and multifocal tumor.Abbreviations: BMI = body mass index, FBG = fasting blood glucose, FNAB = fine needle aspiration biopsy, IGF-1 = insulin-like growth factor-1, LN = lymph node, OR = odds ratio, PTC = papillary thyroid cancer, TNM = tumor-node-metastasis.

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Section: Discussionmentioning

confidence: 97%

Association of obesity with the clinicopathological features of thyroid cancer in a large, operative population

Zhao¹,

Jia²,

Fan³

et al. 2019

Medicine

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“…However, a causal link between obesity and thyroid cancer is not widely accepted. A retrospective study of fine-needle aspiration biopsies of 4849 thyroid nodules showed no relationship between obesity and cancer risk; the incidence of suspicious or malignant nodules did not differ between five BMI groups (normal body weight, overweight, and Grade 1–3 obesity) [ 44 ]. Similarly, no association was found between obesity and thyroid cancer in a study of people undergoing preventive screening for various risk factors for thyroid cancer [ 45 ], nor in one other cohort study [ 24 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

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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“…Indeed, several large scale epidemiology studies have suggested that obesity may increase the risk for thyroid cancer development (9)(10)(11)(12), and also the aggressivity of thyroid cancer if detected (13)(14)(15). However, in contrast, other studies have reported no such association between obesity and thyroid cancer risk (16)(17)(18). One complexity in translating such data into clinical practice is to acknowledge that such large-scale association studies often carry selection or sampling bias.…”

Section: Introductionmentioning

confidence: 99%

Point of Care Measurement of Body Mass Index and Thyroid Nodule Malignancy Risk Assessment

et al. 2022

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BackgroundLarge scale epidemiology studies have suggested obesity may increase the risk of thyroid cancer, though no prospective analyses using real-world measurement of BMI at a time proximate to initial thyroid nodule evaluation have been performed.MethodsWe performed a prospective, cohort analysis over 3 years of consecutive patients presenting for thyroid nodule evaluation. We measured BMI proximate to the time of initial evaluation and correlated this with the final diagnosis of benign or malignant disease. We further correlated patient BMI with aggressivity of thyroid cancer, if detected.ResultsAmong 1,259 consecutive patients with clinically relevant nodules, 199(15%) were malignant. BMI averaged 28.6 kg/m2 (SD: 6.35, range:16.46-59.26). There was no correlation between the measurement of BMI and risk of thyroid cancer (p=0.58) as mean BMI was 28.9 kg/m2 and 28.6 kg/m2 in cancerous and benign cohorts, respectively. Similarly, BMI did not predict aggressive thyroid cancer (p=0.15). While overall nodule size was associated with increased BMI (p<0.01), these data require further validation as obesity may hinder nodule detection until large.ConclusionIn contrast to findings published from large scale association studies drawn from national databases, these prospective data of consecutive patients presenting for nodule evaluation detect no association of obesity (as measured by BMI) with thyroid cancer. Real time measurement of BMI at the time of thyroid nodule evaluation does not contribute to cancer risk assessment.

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Obesity Does Not Modify the Risk of Differentiated Thyroid Cancer in a Cytological Series of Thyroid Nodules

Cited by 25 publications

References 37 publications

Association of obesity with the clinicopathological features of thyroid cancer in a large, operative population

Association of obesity with the clinicopathological features of thyroid cancer in a large, operative population

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

Point of Care Measurement of Body Mass Index and Thyroid Nodule Malignancy Risk Assessment

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