The American Thyroid Association risk stratification and long-term outcomes of differentiated thyroid cancer: a 20-year follow-up of patients in Saudi Arabia.

Background: Studies have reported differing factors associated with poor outcomes in patients with differentiated thyroid cancer (DTC). We aimed to describe our 20 years of experience in the management of thyroid cancer (TC) and identify predictors of treatment outcomes. Methods: We conducted a retrospective review of medical records of patients with TC seen in the Thyroid Center at King Saud University Medical City (KSUMC) in Riyadh, Saudi Arabia, between the years 2000 and 2020. Demographic and clinical data including pathological characteristics were collected. The American Thyroid Association (ATA) risk stratification was determined for all patients at the postoperative period as well as the response to therapy at the final follow-up visit. Results: A total of 674 patients (mean age: 47.21 years) with TC, 571 (84.7%) of which were women, were included. There were 404 (60.0%) patients with ATA low risk, 127 (18.8%) with intermediate risk, and 143 (21.2%) with high-risk histology. Overall, 461 patients (68.4%) had an excellent response to treatment, 65 (9.6%) had an indeterminate response, 83 (12.3%) had a biochemical incomplete response, and 65 (9.6%) had a structural incomplete response. Patients who had an excellent response were mostly ATA low risk (n = 318 of 431, 68.1%), whereas 40 of 65 patients (61.5%) of those with ATA high-risk histology had a structural incomplete response to treatment. There were significantly more women who had an excellent response compared with men. Obesity, lymphovascular invasion, and size of the tumor were significant predictors of worse outcomes to therapy. Conclusion: Tumor size, lymphovascular invasion, and obesity are strong predictors of a worse response to therapy among patients with TC. Patients with obesity should be carefully followed up regardless of their risk stratification in light of the recent compelling evidence associating obesity with thyroid cancer and its higher risk of a worse disease outcome. ATA risk stratification is well correlated with patient long-term outcomes.

Effect of Obesity on Cognitive Function among School Adolescents: A Cross-Sectional Study.

OBJECTIVES: Childhood obesity contributes to the risk of numerous health problems and has become a major global health concern. This study aimed to establish the association between obesity and cognitive function among healthy school adolescents. METHODS: This study was carried out by taking school adolescents (n = 400) from June 2016 to December 2017. The mean age of the participants was 13.93 ± 0.81 years. The students were divided into group A (obese, n = 223) and B (non-obese, n = 177). Cognitive functions were recorded as per study tool of the Cambridge Neuropsychological Test Automated Battery (CANTAB). RESULTS: Severely obese students showed a significant delay in cognitive functions as compared to students with normal BMI. Attention Switching Task (AST)-Latency among students with normal BMI was 647.88 ± 137.59 compared to the students with high BMI (685.08 ± 115.92, p = 0.05), AST-Incongruent was 680.78 ± 142.07 versus 726.76 ± 122.31 (p = 0.02), AST-Percent correct trials was 84.31 ± 10.45 versus 78.09 ± 14.87 (p = 0.001), and Intra-Extra Dimensional Set Shift (IED) Total errors among students with normal BMI was 33.93 ± 21.53 compared to the students with high BMI (42.86 ± 37.27, p = 0.03). CONCLUSION: Cognitive functions including AST-Latency, AST-Incongruent, AST-Percent correct trials, and IED Total errors were significantly weakened in markedly obese students. Significant impairments in their cognitive functions, especially attention, retention, intelligence, and cognitive flexibility, were observed. The findings of this study emphasize the need to involve school adolescents in physical activities to reduce body weight in order to have cognitive functions within normal range and also to minimize obesity-associated complications.