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Clinical Endocrinology

Associations between body mass index and clinico-pathological characteristics of papillary thyroid cancer

Authors

  • Hye Jeong Kim,

    1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
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  • Na Kyung Kim,

    1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
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  • Ji Hun Choi,

    1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
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  • Seo Young Sohn,

    1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
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  • Se Won Kim,

    1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
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  • Sang-Man Jin,

    1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
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  • Hye Won Jang,

    1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
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  • Sunghwan Suh,

    1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
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  • Yong-Ki Min,

    1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
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  • Jae Hoon Chung,

    1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
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  • Sun Wook Kim

    Corresponding author
    • Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
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Correspondence: Sun Wook Kim, Division of Endocrinology and Metabolism, Samsung Medical Center, #50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea. Tel.: (82)10 9933 1653; Fax: (82)2 3410 3849; E-mail: swkimmd@skku.edu

Summary

Objective

Epidemiological studies have demonstrated that excess weight increases the risk of thyroid cancer. However, the associations between excess weight and prognostic factors for thyroid cancer are uncertain. We evaluated the relationships between body mass index (BMI) and clinico-pathological features and outcomes of papillary thyroid cancer (PTC).

Patients and Methods

Retrospective analysis of 2057 patients with PTC was performed. Patients were grouped according to BMI (underweight, normal weight, overweight and obesity)-based World Health Organization standardized categories. Logistic regression models were used to assess the relationships between BMI and clinico-pathological features of PTC. A Cox proportional hazards model was used to examine the association between BMI and disease recurrence.

Results

A 5-kg/m2 increase in BMI was associated with PTC tumours larger than 1 cm [odds ratio (OR) 1·31, P < 0·001], with microscopic extrathyroidal invasion (OR 1·23, P = 0·006), and with advanced tumour-node-metastasis (TNM) stage (OR, 1·30, P = 0·003), which is independent of confounding variables such as gender, age, serum TSH, total cholesterol and fasting glucose level. The multivariate-adjusted OR [95% confidence intervals (CI)] in the overweight (25·0–29·9 kg/m2) and obese (BMI ≥ 30) groups for tumours larger than 1 cm were 1·41 (1·10–1·81) and 2·17 (1·23–3·82), respectively, compared to the normal weight group (BMI 18·5–24·9). The multivariate-adjusted OR (95% CI) for microscopic extrathyroidal extension in the obesity group was 1·88 (1·06–3·32), and the OR for advanced TNM stage in the overweight group was 1·35 (1·02–1·79) compared to the normal weight group. During follow-up (median, 84 month; range, 1–185), 43 patients (2·1%) experienced recurrence. There were no significant differences in recurrence of PTCs among BMI groups.

Conclusions

Higher BMI was strongly associated with larger tumour size, extrathyroidal invasion and advanced TNM stage of PTCs. However, there was no difference in recurrence rate among BMI groups. This study suggests that excess weight is associated with aggressive features of PTCs. Further studies with long-term follow-up are needed to confirm this finding.

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