Abstract
<jats:p> <jats:bold> Relevance. </jats:bold> Papillary thyroid cancer (PTC) is the most common form of differentiated thyroid cancer. The increasing incidence of thyroid cancer coincides with the growing prevalence of obesity and metabolic disorders; however, their impact on the risk of recurrence remains in-sufficiently studied. </jats:p> <jats:p> <jats:bold> Objective.</jats:bold> To evaluate the role of obesity and associated metabolic disorders in determining the risk of PTC recurrence. </jats:p> <jats:p> <jats:bold> Materials and Methods. </jats:bold> The study included 145 patients with verified prostate cancer who underwent surgery until 2023. A retrospective analysis of clinical, anthropometric, and metabolic parameters was performed. The patients were divided into 2 groups: Group 1 – the patients with absence of recurrence of the disease for 5 years or more, Group 2 – the patients with a recurrence of prostate cancer. Body mass index (BMI), waist circumference (WC), duration of obesity, indicators of carbohydrate and lipid metabolism, and the HOMA-IR index were evaluated. ROC analysis and logistic regression were performed. </jats:p> <jats:p> <jats:bold> Results. </jats:bold> Disease recurrence was observed in 16 (11 %) patients, on average 8.9 (4.3–11.2) years after the primary surgical intervention. Patients with recurrence had higher values of BMI (32.23 vs. 26.88 kg/m²; p < 0.001), WC (99.03 vs. 86.02 cm; p< 0.001), HOMA-IR (5.57 vs. 3.25; p < 0.001), and a longer history of obesity (19.02 vs. 10 years; p < 0.001). Threshold values associated with an increased risk of recurrence were: BMI ≥ 28.13 kg/m², obesity duration ≥ 12 years, HOMA-IR ≥ 3.90, WC ≥ 90 cm. Logistic regression showed an independent contribution of all metabolic factors to the risk of recurrence. </jats:p> <jats:p> <jats:bold> Conclusion.</jats:bold> Obesity, its duration, and the severity of metabolic disorders, primarily insulin resistance, are significant predictors of PTC recurrence. The identified threshold values can be used for risk stratification and optimization of patient follow-up. Moreover, all patients had abdominal obesity before and after surgery, suggesting that persistent obesity acts not only as a risk factor for development but also as a powerful driver sustaining the risk of recurrence for many years after treatment. </jats:p>