Body Mass Index and Sporadic Medullary Thyroid Cancer: Insights from a Large Series

Excess adipose tissue has been linked to increased prevalence and aggressiveness in many cancers, but its role in medullary thyroid cancer (MTC) remains unclear. This study analyzed anthropometric and clinical data of a large series of patients with sporadic MTC to assess the impact of excess adipose tissue on MTC prevalence, aggressiveness, and outcome. Patients with obesity presented a less aggressive MTC compared to patients with normal weight or overweight, smaller tumors, lower T and N stages, and lower preoperative calcitonin levels. Somatic mutations occurring in RET and RAS genes did not differ across BMI categories. At the end of follow-up, patients with obesity showed less structural disease, resulting in a lower need for further surgical treatments. These findings suggest that patients with obesity experience less aggressive MTC, potentially due to increased medical examinations in this population.