Korean J Intern Med.  2013 Jan;28(1):62-71. 10.3904/kjim.2013.28.1.62.

Neck circumference correlates with tumor size and lateral lymph node metastasis in men with small papillary thyroid carcinoma

• Kim MR
• Kim SS
• Huh JE
• Lee BJ
• Lee JC
• Jeon YK
• Kim BH
• Kim SJ
• Wang SG
• Kim YK
• Kim IJ

• KMID: 1793220
• DOI: http://doi.org/10.3904/kjim.2013.28.1.62

Abstract

BACKGROUND/AIMS
Obesity is correlated with numerous diseases, including thyroid cancer, but the clinical significance of obesity with regard to the clinical characteristics of thyroid cancer remains unclear. Neck circumference is an index of upper-body adipose tissue distribution.
METHODS
In total, 401 patients with papillary thyroid carcinoma (PTC) measuring < or = 2 cm were included. Neck circumference was measured horizontally at the level just below the thyroid cartilage on preoperative neck computed tomographic images.
RESULTS
Neck circumference correlated significantly with tumor size in men (p = 0.001) but not in women (p = 0.930). Body mass index (BMI) did not significantly correlate with tumor size in either sex. Neck circumference was significantly larger in men with lateral lymph node (LN) metastasis than in those without (p = 0.004). Neck circumference and BMI did not differ significantly in women according to other factors such as tumor size, multifocality, extrathyroid extension, and LN metastasis. Tumor size and the prevalence of lateral LN metastasis in men tended to increase in the middle/large neck circumference subgroup compared with those in the low neck circumference subgroup. Multivariate logistic regression analysis revealed that neck circumference (p = 0.009) was a predictor for the presence of lateral LN metastasis in men. BMI was not a predictive factor for lateral LN involvement in either sex.
CONCLUSIONS
Neck circumference, an indicator of central or visceral obesity but not BMI, may be associated with some prognostic factors in men with small PTC.

Keyword

Body mass index; Neck circumference; Obesity; Papillary thyroid carcinoma

MeSH Terms

Adiposity
Adolescent
Adult
Aged
Anthropometry
Body Mass Index
Carcinoma/*secondary/surgery
Chi-Square Distribution
Cross-Sectional Studies
Female
Humans
Logistic Models
Lymph Nodes/*pathology
Lymphatic Metastasis
Male
Middle Aged
Multivariate Analysis
Neck/*pathology
Obesity/*diagnosis/pathology/physiopathology
Odds Ratio
Predictive Value of Tests
Prognosis
Risk Factors
Sex Factors
Thyroid Neoplasms/*pathology/secondary/surgery
Tomography, X-Ray Computed
*Tumor Burden
Young Adult