Thyroid cancer incidence and clinicopathological distribution in bariatric surgery cases

Abstract

Aim: Obesity is strongly associated with increased risk of many cancer types. It is estimated that approximately 20% of all cancers are caused by overweight. It is considered that there is a direct relation between overweight and thyroid cancer. The aim of this study is to evaluate the incidence and clinicopathological distribution of thyroid cancer in bariatric surgery cases. Materials and Methods: The present study was conducted with a total of 2316 patients who underwent bariatric surgery because of morbid obesity in our metabolic and bariatric surgery clinic between April 2014 and November 2021. Results: It was found that the prevalence of thyroid cancer was 1.2% in morbidly obese cases. A total of 23 patients had papillary thyroid cancer (0.99%), 3 patients had follicular cancer (0.12%), 1 patient had medullary cancer (0.04%), and 1 patient had anaplastic cancer (0.04%). Conclusion: It was found in the present study that the most common cancer type was thyroid papillary cancer, and follicular, medullary, and anaplastic cancer were found to be less frequently. There appears to be a relation between Body Mass Index and the thyroid cancer risk.

Keywords

• Bariatric surgery
• obesity
• thyroid cancers
• histopathological distribution

Project Number

yoktur

Bariatrik cerrahi olgularında tiroid kanseri insidansı ve klinikopatolojik dağılımı

Abstract

Amaç: Obezite, birçok kanser türünün artan riski ile güçlü bir şekilde ilişkilidir. Tüm kanserlerin yaklaşık %20'sinin aşırı kilodan kaynaklandığı tahmin edilmektedir. Fazla kilo ile tiroid kanseri arasında doğrudan bir ilişki olduğu düşünülmektedir. Bu çalışmada amaç Bariatrik cerrahi olgularında tiroid kanseri insidansı ve klinikopatolojik dağılımını değerlendirmektir. Gereç ve Yöntem: Bu çalışma, Nisan 2014 ile Kasım 2021 tarihleri arasında metabolik ve obezite cerrahisi kliniğimizde morbid obezite nedeniyle obezite cerrahisi uygulanan toplam 2316 hasta ile gerçekleştirildi. Bulgular: Morbid obez olgularda tiroid kanseri prevalansının %1,2 olduğu saptandı. Toplam 23 hastada papiller tiroid kanseri (%0,99), 3 hastada foliküler kanser (%0,12), 1 hastada medüller kanser (%0,04) ve 1 hastada anaplastik kanser (%0,04) vardı. Sonuç: Bu çalışmada en sık görülen kanser tipinin tiroid papiller kanseri olduğu ve foliküler, medüller ve anaplastik kanserlerin daha az sıklıkta olduğu saptandı. Vücut Kitle İndeksi ile tiroid kanseri riski arasında bir ilişki var gibi görünmektedir.

Keywords

• Bariatrik cerrahi
• obezite
• tiroid kanserleri
• histopatolojik dağılım

Supporting Institution

yoktur

Project Number

yoktur

Thanks

yoktur

References

1. 1. Amer A, Franchi L, Kanneganti TD, et al. Regulation of Legionella phagosome maturation and infection through flagellin and host Ipaf. J Biol Chem. 2006; 17;281(46):35217-23. doi: 10.1074/jbc.M604933200.
2. 2. Iyengar NM, Hudis CA, Dannenberg AJ. Obesity and cancer: local and systemic mechanisms. Annu Rev Med. 2015; 66:297-309. doi: 10.1146/annurev-med-050913-022228. PMID: 25587653.
3. 3. Filetti S, Durante C, Hartl D, et al. Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Ann Oncol. 2019; 1;30(12):1856-1883. doi: 10.1093/annonc/mdz400. PMID: 31549998.
4. 4. Kitahara CM, Sosa JA. The changing incidence of thyroid cancer. Nat Rev Endocrinol. 2016; 12(11):646-653. doi: 10.1038/nrendo.2016.110. Epub 2016 Jul 15. PMID: 27418023.
5. 5. Roman BR, Morris LG, Davies L. The thyroid cancer epidemic, 2017 perspective. Curr Opin Endocrinol Diabetes Obes. 2017; 24(5):332-336. doi: 10.1097/MED.0000000000000359. PMID: 28692457; PMCID: PMC5864110.
6. 6. Sharen G, Zhang B, Zhao R, et al. Retrospective epidemiological study of thyroid nodules by ultrasound in asymptomatic subjects. Chin Med J (Engl). 2014;127(9):1661-5. PMID: 24791871.
7. 7. Ali A, Mirza Y, Faizan U, et al. Association of Obesity and Thyroid Cancer at a Tertiary Care Hospital in Pakistan. Cureus. 2018; 26;10(3):e2364. doi: 10.7759/cureus.2364. PMID: 29805933; PMCID: PMC5969796.
8. 8. Brito H, Santos AC, Preto J. et al. Obesity and Cancer: the Profile of a Population who Underwent Bariatric Surgery. OBES SURG. 2021; 31, 4682–4691 https://doi.org/10.1007/s11695-021-05626-0.

9. 9. Güzel K, Ocak ÖK, Ergenc H, et al. Cancers Detected During the Evaluation Before Bariatric Surgery in Obese Patients: a High-Risk Population for Cancers and Their Prevalence. Obes Surg. 2021; 21. doi: 10.1007/s11695-021-05747-6. Epub ahead of print. PMID: 34674140.
10. 10. Davies L, Morris LG, Haymart M, et al. american association of clinical endocrinologists and american college of endocrinology disease state clinical review: the increasing incidence of thyroid cancer. Endocr Pract. 2015; 21(6):686-96. doi: 10.4158/EP14466.DSCR. PMID: 26135963; PMCID: PMC4923940.
11. 11. Russ G, Bonnema SJ, Erdogan MF, et al. European Thyroid association guidelines for ultrasound malignancy risk stratification of thyroid nodules in adults: The EU-TIRADS. Eur Thyroid J, 2017; 6:225–37. doi: 10.1159/000478927.
12. 12. European Network of Cancer Registries Factsheets. https://www.encr. eu/sites/default/files/factsheets/ENCR_Factsheet_Thyroid_2017.pdf (12 June 2019, date last accessed).
13. 13. Dal Maso L, Tavilla A, Pacini F, et al. Survival of 86,690 patients with thyroid cancer: a population-based study in 29 European countries from EUROCARE-5. Eur J Cancer, 2017; 77: 140–152.
14. 14. Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab. 2008;22(6):901-11. doi: 10.1016/j.beem.2008.09.019. PMID: 19041821.
15. 15. de Siqueira RA, Rodrigues APDS, Miamae LM, et al. Thyroid Nodules in Severely Obese Patients: Frequency and Risk of Malignancy on Ultrasonography. Endocr Res. 2020; 45(1):9-16. doi: 10.1080/07435800.2019.1625056. Epub 2019 Jul 1. PMID: 31256691.
16. 16. Machens A, Hinze R,Thomusch O, et al. Pattern of nodal metastasis for primary and reoperative thyroid cancer. World Journal of Surgery. 2002; 26(1):22–28. doi: 10.1007/s00268-001-0176-3. 17. Zhang AB, Liu LF, Lu C, et al. Risk factors of central neck lymph node metastasis in cN0 papillary thyroid carcinoma. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Aug 5;31(15):1141-1145. Chinese. doi: 10.13201/j.issn.1001-1781.2017.15.001. PMID: 29798345.
17. 18. Lauby-Secretan B, Scoccianti C, Loomis D, et al. Body Fatness and Cancer--Viewpoint of the IARC Working Group. N Engl J Med. 2016 Aug 25;375(8):794-8. doi: 10.1056/NEJMsr1606602. PMID: 27557308; PMCID: PMC6754861.
18. 19. Calle EE, Rodriguez C, Walker-Thurmond K, et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003; 24; 348(17):1625-38.
19. 20. Reeves GK, Pirie K, Beral V, et al. Cancer incidence and mortality in relation to body mass index in the Million Women Study: cohort study. BMJ. 2007 Dec 1; 335(7630):1134.
20. 21. Brito H, Santos AC, Preto J. et al. Obesity and Cancer: the Profile of a Population who Underwent Bariatric Surgery. OBES SURG. 2021; 31, 4682–4691.https://doi.org/10.1007/s11695-021-05626-0.
21. 22. Güzel K, Ocak ÖK, Ergenc H, et al. Cancers Detected During the Evaluation Before Bariatric Surgery in Obese Patients: a High-Risk Population for Cancers and Their Prevalence. Obes Surg. 2021; 21. doi: 10.1007/s11695-021-05747-6. Epub ahead of print. PMID: 34674140.
22. 23. Kitahara CM, Platz EA, Freeman LE, et al. Obesity and thyroid cancer risk among U.S. men and women: a pooled analysis of five prospective studies. Cancer Epidemiol Biomarkers Prev. 2011; 20(3):464-72. doi: 10.1158/1055-9965.EPI-10-1220. Epub 2011 Jan 25. PMID: 21266520; PMCID: PMC3079276.
23. 24. Dal Maso L, La Vecchia C, Franceschi S, et al. A pooled analysis of thyroid cancer studies. V. Anthropometric factors. Cancer Causes Control. 2000 Feb;11(2):137-44. doi: 10.1023/a:1008938520101. PMID: 10710197.
24. 25. Ma J, Huang M, Wang L, et al. Obesity and risk of thyroid cancer: evidence from a meta-analysis of 21 observational studies. Med Sci Monit. 2015; 22;21:283-91. doi: 10.12659/MSM.892035. PMID: 25612155; PMCID: PMC4315628.
25. 26. Choi JS, Kim EK, Moon HJ, et al. Higher body mass index may be a predictor of extrathyroidal extension in patients with papillary thyroid microcarcinoma. Endocrine. 2015; 48(1):264-71. doi: 10.1007/s12020-014-0293-z. Epub 2014 May 25. PMID: 24858734.
26. 27. Quail DF, Dannenberg AJ. The obese adipose tissue microenvironment in cancer development and progression. Nat Rev Endocrinol. 2019; 15(3):139-154. doi: 10.1038/s41574-018-0126-x.
27. 28. Boelaert K, Horacek J, Holder RL, et al. Serum thyrotropin concentration as a novel predictor of malignancy in thyroid nodules investigated by fine-needle aspiration. J Clin Endocrinol Metab. 2006; 91(11):4295-301. doi: 10.1210/jc.2006-0527. Epub 2006 Jul 25. PMID: 16868053.
28. 29. Gokosmanoglu F, Aksoy E, Onmez A, et al. Thyroid Homeostasis After Bariatric Surgery in Obese Cases. Obes Surg. 2020;30(1):274-278. doi: 10.1007/s11695-019-04151-5. PMID: 31617112.
29. 30. Tunçez E, Kulaksızoğlu M, Tunöez IK. The Relationship Between TSH Level and Stage of Differentiated Thyroid Carcinoma. Turk J Endocrinol Metab. 2020;24:230-236. DOI: 10.25179/tjem.2020-74747.
30. 31. Tamez-Pérez HE, Martínez E, Quintanilla-Flores DL, et al. The rate of primary hypothyroidism in diabetic patients is greater than in the non-diabetic population. An observational study. Med Clin (Barc). 2012; 28;138(11):475-7. doi: 10.1016/j.medcli.2011.08.009. Epub 2011 Dec 26. PMID: 22204860.
31. 32. Li H, Qian J. Association of diabetes mellitus with thyroid cancer risk: A meta-analysis of cohort studies. Medicine (Baltimore). 2017; 96(47):e8230. doi: 10.1097/MD.0000000000008230. PMID: 29381912; PMCID: PMC5708911.
32. 33. Vaccarella S, Franceschi S, Bray F, et al. Worldwide Thyroid-Cancer Epidemic? The Increasing Impact of Overdiagnosis. N Engl J Med. 2016; 18;375(7):614-7. doi: 10.1056/NEJMp1604412. PMID: 27532827.
33. 34. Girardi FM, Barra MB, Zettler CG. Variants of papillary thyroid carcinoma: association with histopathological prognostic factors. Braz J Otorhinolaryngol. 2013; 79(6):738-44. English, Portuguese. doi: 10.5935/1808-8694.20130135. PMID: 24474487.