Sarcopenia Increases the Risk of Major Organ Invasion in Patients with Papillary Thyroid Cancer

While sarcopenia is associated with poor overall survival and cancer-specific survival in solid cancer patients, the impact of sarcopenia on clinicopathologic features that can influence conventional papillary thyroid cancer (PTC) prognosis remains unclear. To investigate the impact of sarcopenia on aggressive clinicopathologic features in PTC patients, prospectively collected data on 305 patients who underwent surgery for PTC with preoperative staging ultrasonography and bioelectrical impedance analysis were retrospectively analyzed. Nine sarcopenia patients showed more patients aged 55 or older ( p  = 0.022), higher male proportion ( p  < 0.001), lower body-mass index ( p  = 0.015), higher incidence of major organ invasion ( p  = 0.001), higher T ( p  = 0.002) stage, higher TNM ( p  = 0.007) stage, and more tumor recurrence ( p  = 0.023) compared to the non-sarcopenia patients. Unadjusted and adjusted logistic regression analyses showed that sarcopenia (odds ratio (OR) 9.936, 95% confidence interval (CI) 2.052–48.111, p  = 0.004), tumor size (OR 1.048, 95% CI 1.005–1.093, p  = 0.027), and tumor multiplicity (OR 3.323, 95% CI 1.048–10.534, p  = 0.041) significantly increased the risk of major organ invasion. Therefore, sarcopenia in PTC patients should raise suspicion for a more locally advanced disease and direct appropriate management.