Metabolic Syndrome as a Prognostic Factor in Papillary Thyroid Cancer Patients
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Purpose: Metabolic syndrome (MetS) is considered a risk factor and poor prognostic factor for several cancers, and increases the risk of thyroid cancer and aggressiveness of papillary thyroid cancer (PTC). Here, we investigated the association between a poor prognosis in patients with PTC, and MetS. Methods: Patients diagnosed with PTC who underwent thyroidectomy between January 2013 and December 2015 at our institution were included (n=789). We divided patients into two groups according to the presence of MetS—defined as three or more of the following criteria: central obesity, hypertension, insulin resistance, low high-density lipoprotein cholesterol, and high triglycerides—identified by retrospective medical record review. We analyzed the clinicopathologic factors between the two groups, univariate and multivariate analyses were performed, and survival outcomes were analyzed by propensity score matching. Results: The mean patient age and median follow-up period were 47.0±11.2 years and 6.14 years, respectively; 119 patients (15.1%) were diagnosed with MetS. Significant differences between groups were identified regarding sex, age, operation extent, central neck dissection, lateral neck dissection, extrathyroidal extension (ETE), lateral lymph node metastasis, T stage, N stage, and radioactive iodine therapy. Old age, ETE, and MetS were identified as prognostic factors of recurrence-free survival (RFS) in the multivariate analysis. The 5-year RFS rates were 94.9% and 99.1% in the non-MetS and MetS groups, respectively, which was statistically significant (P=0.021). Conclusion: MetS is a prognostic factor for RFS among patients with PTC in our hospital.
Abstract
Purpose: Metabolic syndrome (MetS) is considered a risk factor and poor prognostic factor for several cancers, and increases the risk of thyroid cancer and aggressiveness of papillary thyroid cancer (PTC). Here, we investigated the association between a poor prognosis in patients with PTC, and MetS. Methods: Patients diagnosed with PTC who underwent thyroidectomy between January 2013 and December 2015 at our institution were included (n=789). We divided patients into two groups according to the presence of MetS—defined as three or more of the following criteria: central obesity, hypertension, insulin resistance, low high-density lipoprotein cholesterol, and high triglycerides—identified by retrospective medical record review. We analyzed the clinicopathologic factors between the two groups, univariate and multivariate analyses were performed, and survival outcomes were analyzed by propensity score matching. Results: The mean patient age and median follow-up period were 47.0±11.2 years and 6.14 years, respectively; 119 patients (15.1%) were diagnosed with MetS. Significant differences between groups were identified regarding sex, age, operation extent, central neck dissection, lateral neck dissection, extrathyroidal extension (ETE), lateral lymph node metastasis, T stage, N stage, and radioactive iodine therapy. Old age, ETE, and MetS were identified as prognostic factors of recurrence-free survival (RFS) in the multivariate analysis. The 5-year RFS rates were 94.9% and 99.1% in the non-MetS and MetS groups, respectively, which was statistically significant (P=0.021). Conclusion: MetS is a prognostic factor for RFS among patients with PTC in our hospital.
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