# Body Mass Index and Its Association With Clinical and Pathological Features of Papillary Thyroid Carcinoma: A Retrospective Analysis

## TL;DR

This study finds that higher body mass index is linked to more aggressive features in papillary thyroid cancer, especially in women.

## Contribution

The study provides new evidence linking high BMI to aggressive pathological features in papillary thyroid carcinoma.

## Key findings

- High BMI was significantly associated with larger tumor size in PTC patients.
- Obesity correlated with more aggressive features like extrathyroidal invasion and vascular invasion.
- Female sex and high BMI were both significantly linked to tumor progression.

## Abstract

Introduction

Papillary thyroid carcinoma (PTC) is a differentiated thyroid tumor. Its association with obesity and high body mass index has been suggested. This study investigates the potential link between elevated body mass index and aggressive features of PTC.

Materials and methods

A descriptive and analytical retrospective study was conducted on patients followed between January 2020 and January 2025 at the Nuclear Medicine and Endocrinology and Metabolic Diseases departments of Centre Hospitalier Universitaire (CHU; University Hospital Center) Hassan II in Fez. The inclusion criteria were patients >18 years old with PTC only. Patients with other histological types or conditions interfering with BMI were excluded. Epidemiological, clinical, pathological, and follow-up data were systematically collected. Data were compiled and analyzed using Microsoft Excel software (Microsoft Corporation, Redmond, USA).

Results

We included 243 cases: 78 men (25.4%) and 165 women (74.6%). The mean age was 45 ± 12 years. The median BMI was 29.4 kg/m2, with 95 patients (39.09%) being overweight and 104 (42.7%) being obese. Postoperative anatomopathological analysis revealed a mean tumor size of 26.4 mm and a mean number of 9 ± 5 removed lymph nodes (LNs). Extrathyroidal invasion was found in 149 cases (61.3%), vascular invasion in 114 cases (46.9%), multifocal PTC in 59 cases (24.27%), cervical LN metastasis in 42 cases (17.28%), and extra-cervical metastasis in 17 patients (6.9%). A total of 81 cases (33.3%) presented with tumor-node-metastasis (TNM) stage III or IV. Statistical analysis showed a significant association between high BMI, female sex, and tumor size (p<0.05).

Conclusion

Our study shows that high BMI is correlated with some aggressive histological outcomes of PTC. Further studies are required to establish this impact in order to guide treatment and have favorable outcomes.