Obesity and Overweight Are Associated with Minimal Extrathyroidal Extension, Multifocality and Bilaterality of Papillary Thyroid Cancer

Epidemiological studies have shown a strong association between high body mass index (BMI) and papillary thyroid cancer (PTC). We assessed the clinical and histopathological features of PTC in patients with a higher BMI and compared them to analogous parameters in PTC patients with a normal BMI. We retrospectively analyzed 5021 medical records of patients admitted and surgically treated for thyroid tumors in one center between 2008 and 2018. Finally, we extracted data from 523 adult patients with PTC and stratified patients into two groups according to BMI: Group 1 with BMI < 25 kg/m2 and Group 2 with BMI ≥ 25 kg/m2. Data stratification was performed to estimate the association of overweight and obesity with clinical and histopathological features of PTC in both univariable and multivariable binary logistic regression analyses. Overall, compared to patients with a normal BMI, overweight and obese patients had a greater risk of minimal extrathyroidal extension (minimal ETE), multifocality and bilaterality of PTC (p < 0.001 for all). Analysis did not show that BMI was significantly associated with the more advanced tumor-node-metastasis (TNM) stage (p = 0.894). Obesity and overweight were significantly associated with higher aggressiveness of PTC. When considering various management options for PTC patients, these findings regarding overweight and obesity should be taken into consideration during the decision-making process.

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Editorial: How clinically significant is minimal extrathyroidal extension in papillary thyroid cancer?

Surgery ◽

10.1016/j.surg.2015.07.048 ◽

2016 ◽

Vol 159 (1) ◽

pp. 22

Author(s):

Nancy D. Perrier ◽

Adel K. El-Naggar

Keyword(s):

Thyroid Cancer ◽

Papillary Thyroid Cancer ◽

Extrathyroidal Extension ◽

Papillary Thyroid ◽

Clinically Significant ◽

Minimal Extrathyroidal Extension

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The impact of minimal extrathyroidal extension in the recurrence of papillary thyroid cancer patients

Archives of Endocrinology and Metabolism ◽

10.20945/2359-3997000000245 ◽

2020 ◽

Vol 64 (3) ◽

pp. 251-256

Author(s):

Maria Fernanda Ozorio de Almeida ◽

Júlia Soares Couto ◽

Ana Luiza Trevizani Ticly ◽

Vivian Cenize Guardia ◽

Marilia Martins Silveira Marone ◽

...

Keyword(s):

Thyroid Cancer ◽

Cancer Patients ◽

Papillary Thyroid Cancer ◽

Extrathyroidal Extension ◽

Papillary Thyroid ◽

The Impact ◽

Minimal Extrathyroidal Extension

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MON-533 Diffuse Sclerosing Variant Papillary Thyroid Cancer: Clinical and Histopathological Features, Mutational Profile, Management and Outcome

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1096 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Abeer Abdulhadi Aljomaiah ◽

Yosra Moria ◽

Nora Aldaej ◽

Meshael Alswailem ◽

Ali Saeed Alzahrani

Keyword(s):

Thyroid Cancer ◽

Lymph Node ◽

Molecular Genetics ◽

Papillary Thyroid Cancer ◽

Distant Metastases ◽

The Other ◽

Papillary Thyroid ◽

Histopathological Features ◽

Diffuse Sclerosing Variant

Abstract Diffuse sclerosing variant (DSV) is a rare subtype of papillary thyroid cancer (PTC). Whether it represents a higher grade subtype than conventional PTC is not quite clear. Furthermore, there are limited data on its long-term outcome and its molecular genetics. In this report, we studied all cases of DSV PTC seen at our center during the last 20 years. Out of more than 6000 patients (pts) with differentiated thyroid cancer, only 37 were DSV. We reviewed the clinical and histopathological features, management and outcome of these cases. In addition, molecular genetics is partially achieved; 17 out of these 37 cases have been genotyped for BRAFV600E, TERT promotor mutations, NRAS, HRAS and KRAS mutations. The molecular profiling of the other 20 cases is being done. A total of 37 pts were studied {(12 Males:25 Females, median age 21 years (8-89)}. One pt had lobectomy and the other 36 pts (97.3%) had a total thyroidectomy. Central only (4 pts) or central/lateral lymph node dissection (29 pts) were performed. The median tumor size was 4.5 cm (1.5-8.1). The tumor was multifocal in 27 cases (73%), with extrathyroidal invasion in 27 (73%) and lymphovascular invasion in 24 pts (64.8%). A background lymphocytic thyroiditis was present in 12 pts (32.4%). Lymph node metastases were present in 34 pts (92%) and distant metastases in 13 pts (35%). The sites of metastasis are lungs in 12 pts (32.4%) and lungs and bone in 1 pt. Twenty pts (54.1%) were in TNM8 stage 1, 10 pts (27%) in stage 2, 1 (2.7%) in stage 4a, 3 (8.1%) in stage 4b and 3 unstageable. The ATA risk classification for these pts was 4 pts (10.8%) in low, 12 (32.4%) in intermediate, 19 (51.4%) in high-risk groups and 2 could not be assessed. I-131 was administered to 33 pts (89.2%). The median administered activity was 136 mCi (46-218). Fifteen pts (40.5%) received additional therapies (3 surgeries, 7 RAI, 5 surgeries, and RAI). In 17 pts (46%) which were genotyped, only 3 tumors (8.1%) had BRAFV600E mutation, 1 (2.7%) had TERT promotor C228T mutation and none had RAS mutations. At the last follow up, 15 pts (40.5%) achieved an excellent response, 9 (24%) an indeterminate response, 6 (16.2%) with a structural disease, and 7 (19%) were lost for follow up. Conclusion: DSV PTC is a rare variant, occurs mostly in adolescent and young pts, characterized by aggressive histopathological features and high rates of lymph node and distant metastases but the commonly reported mutations in PTC are rare in DSV and mortality is absent.

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