Papillary thyroid carcinoma and obesity: Impact of BMI on clinicopathological aggressiveness criteria

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Published Jul 12, 2026
https://doi.org/10.62438/tunismed.v104i07.5902
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Vol. 104 No. 07 (2026): Tunis Med Jul 2026

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Jihene Houas
ENT Department and Cervical Surgery Farhat Hached Hospital, University of Sousse, Tunisia
Monia Ghammam
ENT Department and Cervical Surgery Farhat Hached Hospital, University of Sousse, Tunisia
Heyfa Belhadj-Miled
ENT Department and Cervical Surgery Farhat Hached Hospital, University of Sousse, Tunisia
Sana Bhiri
Prevention and Security of Care Department, Sahloul Hospital, University of Sousse, Tunisia
Wassim Kermani
ENT Department and Cervical Surgery Farhat Hached Hospital, University of Sousse, Tunisia
Mohamed Abdelkefi
ENT Department and Cervical Surgery Farhat Hached Hospital, University of Sousse, Tunisia

Abstract

Background: The global incidence of papillary thyroid carcinoma (PTC) has risen significantly, with obesity emerging as a potential risk factor. This study aims to assess the association between obesity, overweight, and aggressive characteristics of PTC.
Methods: A retrospective study was conducted at our hospital, including patients operated for PTC between 2014 and 2024. Body mass index (BMI) was classified per WHO criteria: normal weight (BMI < 25 kg/m²), overweight (25–29.9 kg/m²), and obese (≥30 kg/m²). Clinical and histopathological characteristics were analyzed using SPSS v26.0. Statistical significance was set at p < 0.05.
Results: A total of 120 patients were treated for PTC over a 11-year period, including 95 women and 25 men. Of these, 41 patients had a normal BMI, 40 were overweight and 39 were classified as obese. The results of this study show that, although obesity was associated with variations in patient
age(p=0.004) and sex(p=0.009), it did not have a statistically significant impact on tumor size(p=0.117), ETE (p=0.736), multifocality (p=0.119) or bilaterality (p=0.754). Furthermore, the presence of vascular invasion (p=0.472) or lymph node metastases (p=0.700) was not influenced by BMI.
Finally, the rates of post-operative complications (p=0.970) and recurrence (p=0.844) were low and comparable between the different groups.
Conclusion: Obesity does not appear to significantly influence PTC aggressiveness in this cohort. While trends in multifocality warrant further investigation, larger prospective studies are needed to clarify the impact of BMI on PTC prognosis.

Keywords:

obesity, body mass index, papillary thyroid carcinoma, prognosis

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References

  1. Wang C, Wu Z, Lei L, Dong X, Cao W, Luo Z, et al. Geographic disparities in trends of thyroid cancer incidence and mortality from
  2. to 2019 and a projection to 2030 across income-classified countries and territories. J Glob Health. 2023;13:04108.
  3. Hajeer MH, Awad HA, Abdullah NI, Almuhaisen GH, Abudalu LE. The rising trend in papillary thyroid carcinoma. Saudi Med J. févr
  4. ;39(2):147-53.
  5. Wiltshire JJ, Drake TM, Uttley L, Balasubramanian SP. Systematic Review of Trends in the Incidence Rates of Thyroid Cancer. Thyroid®.
  6. nov 2016;26(11):1541-52.
  7. Mirkatouli NB, Hirota S, Yoshinaga S. Thyroid cancer risk after radiation exposure in adults—systematic review and meta-analysis.
  8. Journal of Radiation Research. 1 nov 2023;64(6):893-903.
  9. Saenko V, Mitsutake N. Radiation-Related Thyroid Cancer. Endocrine Reviews. 4 janv 2024;45(1):1-29.
  10. Franchini F, Palatucci G, Colao A, Ungaro P, Macchia PE, Nettore IC. Obesity and Thyroid Cancer Risk: An Update. Int J Environ Res
  11. Public Health. 20 janv 2022;19(3):1116.
  12. WHO Consultation on Obesity (1999: Geneva S, Organization WH. Obesity: preventing and managing the global epidemic: report of
  13. a WHO consultation [Internet]. World Health Organization; 2000. Disponible sur: https://iris.who.int/handle/10665/42330
  14. Xu G, Chen B, China WG for EC on CM of TC with ORT in. Expert Consensus on Clinical Management of T2DM Combined with
  15. Obesity Reversal Treatment in China (2023). Anticancer Res. 2023;7(6):40-51
  16. Calle EE, Kaaks R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer. août
  17. ;4(8):579-91.
  18. O’Neill. Association of BMI with Clinicopathological Features of Papillary Thyroid Cancer: A Systematic Review and Meta-Analysis.
  19. World J Surg. 2021;(45):2805-15.
  20. Lengyel E, Makowski L, DiGiovanni J, Kolonin MG. Cancer as a matter of fat: The crosstalk between adipose tissue and tumors.
  21. Trends Cancer. mai 2018;4(5):374-84.
  22. Pazaitou-Panayiotou K, Polyzos SA, Mantzoros CS. Obesity and thyroid cancer: epidemiologic associations and underlying
  23. mechanisms. Obes Rev. déc 2013;14(12):1006-22.
  24. 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. 1 juin 2014;24(6):966-74.
  25. Engeland A, Tretli S, Akslen LA, Bjørge T. Body size and thyroid cancer in two million Norwegian men and women. Br J Cancer. 7
  26. août 2006;95(3):366-70.
  27. Zhao ZG, Guo XG, Ba CX, Wang W, Yang YY, Wang J, et al. Overweight, obesity and thyroid cancer risk: a meta-analysis of cohort studies. J Int Med Res. 2012;40(6):2041-50.
  28. Kitahara CM, Platz EA, Freeman LEB, Hsing AW, Linet MS, Park Y, et al. Obesity and Thyroid Cancer Risk among U.S. Men and Women:
  29. A Pooled Analysis of Five Prospective Studies. Cancer Epidemiology, Biomarkers & Prevention. 7 mars 2011;20(3):464-72.
  30. Li CL, Dionigi G, Zhao YS, Liang N, Sun H. Influence of body mass index on the clinicopathological features of 13,995 papillary thyroid
  31. tumors. J Endocrinol Invest. sept 2020;43(9):1283-99.
  32. 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. nov 2014;156(5):1145-52.
  33. Choi JS, Kim EK, Moon HJ, Kwak JY. Higher body mass index may be a predictor of extrathyroidal extension in patients with papillary
  34. thyroid microcarcinoma. Endocrine. févr 2015;48(1):264-71.
  35. Seo Ki Kim, Jung-Woo Woo, Inhye Park, Jun Ho Lee. Influence of Body Mass Index and Body Surface Area on the Behavior of Papillary
  36. Thyroid Carcinoma | Thyroid®. Thyroid. 2016;26(5):657-66.
  37. Yu S tong, Chen W, Cai Q, Liang F, Xu D, Han P, et al. Pretreatment BMI Is Associated with Aggressive Clinicopathological Features of
  38. Papillary Thyroid Carcinoma: A Multicenter Study. International Journal of Endocrinology. 2017;2017(1):5841942.
  39. Kim H, Kwon H, Moon BI. Predictors of Recurrence in Patients with Papillary Thyroid Carcinoma: Does Male Sex Matter? Cancers
  40. (Basel). 9 avr 2022;14(8):1896.
  41. kim hye jeong. Associations between body mass index and clinico-pathological characteristics of papillary thyroid cancer - Kim
  42. - 2013 - Clinical Endocrinology - Wiley Online Library. CLINICAL ENDOCRINOLOGY. 2013;78:134-40.
  43. Liu Z, Maimaiti Y, Yu P, Xiong Y, Zeng W, Li X, et al. Correlation between body mass index and clinicopathological features of
  44. papillary thyroid microcarcinoma. Int J Clin Exp Med. 15 sept 2015;8(9):16472-9.
  45. Grani G, Lamartina L, Montesano T, Ronga G, Maggisano V, Falcone R, et al. Lack of association between obesity and aggressiveness
  46. of differentiated thyroid cancer. J Endocrinol Invest. 1 janv 2019;42(1):85-90.
  47. Zaman SU, Awan MS, Sulaiman MA. Obesity and High Risk Pathological Features of Papillary Thyroid Carcinoma: A
  48. Retrospective Analysis of a University Hospital in Pakistan. Gulf J Oncolog. mai 2018;1(27):6-10.
  49. Kim SH, Park HS, Kim KH, Yoo H, Chae BJ, Bae JS, et al. Correlation between obesity and clinicopathological factors in patients with
  50. papillary thyroid cancer. Surg Today. juin 2015;45(6):723-9.
  51. Jin Q feng. Impact of BMI on Complications and Satisfaction in Patients With Papillary Thyroid Cancer and Lateral Neck Metastasis
  52. - Qiu-feng Jin, Qi-gen Fang, Jin-xing Qi, Peng Li, 2019. 2019;26:1-6