TY - JOUR
T1 - Does BRAF V600e mutation predict aggressive features in papillary thyroid cancer? results from four endocrine surgery centers
AU - Li, Carol
AU - Aragon Han, Patricia
AU - Lee, Kathleen C.
AU - Lee, Louis C.
AU - Fox, Amy C.
AU - Beninato, Toni
AU - Thiess, Michele
AU - Dy, Benzon M.
AU - Sebo, Thomas J.
AU - Thompson, Geoffrey B.
AU - Grant, Clive S.
AU - Giordano, Thomas J.
AU - Gauger, Paul G.
AU - Doherty, Gerard M.
AU - Fahey, Thomas J.
AU - Bishop, Justin
AU - Eshleman, James R.
AU - Umbricht, Christopher B.
AU - Schneider, Eric B.
AU - Zeiger, Martha A.
PY - 2013/9
Y1 - 2013/9
N2 - Background: Existing evidence is controversial regarding the association between BRAF mutation status and aggressive features of papillary thyroid cancer (PTC). Specifically, no study has incorporated multiple surgical practices performing routine central lymph node dissection (CLND) and thus has patients who are truly evaluable for the presence or absence of central lymph node metastases (CLNMs). Methods: Consecutive patientswhounderwent total thyroidectomy and routine CLND at 4 tertiary endocrine surgery centers were retrospectively reviewed. Descriptive and bivariable analyses examined demographic, patient, and tumor-related factors. Multivariable analyses examined the odds of CLNM associated with positive BRAF status. Results: In patients with classical variant PTC, bivariate analysis found no significant associations between BRAF mutation and aggressive clinicopathologic features; multivariate analysis demonstrated that BRAF status was not an independent predictor of CLNM. When all patients with PTC were analyzed, including those with aggressive or follicular subtypes, bivariate analysis showed BRAF mutation to be associated with LNM, advanced American Joint Committee on Cancer (AJCC) stage, and histologic subtype. Multivariable analyses showed BRAF, age, size, and extrathyroidal extension to be associated with CLNM. Conclusion: Although BRAF mutation was found to be an independent predictor of central LNM in the overall cohort of patients with PTC, this relationship lost significance when only classical variant PTC was included in the analysis. The usefulness of BRAF in predicting the presence of LNM remains questionable. Prospective studies are needed before BRAF mutation can be considered a reliable factor to guide the treatment of patients with PTC, specifically whether to perform prophylactic CLND.
AB - Background: Existing evidence is controversial regarding the association between BRAF mutation status and aggressive features of papillary thyroid cancer (PTC). Specifically, no study has incorporated multiple surgical practices performing routine central lymph node dissection (CLND) and thus has patients who are truly evaluable for the presence or absence of central lymph node metastases (CLNMs). Methods: Consecutive patientswhounderwent total thyroidectomy and routine CLND at 4 tertiary endocrine surgery centers were retrospectively reviewed. Descriptive and bivariable analyses examined demographic, patient, and tumor-related factors. Multivariable analyses examined the odds of CLNM associated with positive BRAF status. Results: In patients with classical variant PTC, bivariate analysis found no significant associations between BRAF mutation and aggressive clinicopathologic features; multivariate analysis demonstrated that BRAF status was not an independent predictor of CLNM. When all patients with PTC were analyzed, including those with aggressive or follicular subtypes, bivariate analysis showed BRAF mutation to be associated with LNM, advanced American Joint Committee on Cancer (AJCC) stage, and histologic subtype. Multivariable analyses showed BRAF, age, size, and extrathyroidal extension to be associated with CLNM. Conclusion: Although BRAF mutation was found to be an independent predictor of central LNM in the overall cohort of patients with PTC, this relationship lost significance when only classical variant PTC was included in the analysis. The usefulness of BRAF in predicting the presence of LNM remains questionable. Prospective studies are needed before BRAF mutation can be considered a reliable factor to guide the treatment of patients with PTC, specifically whether to perform prophylactic CLND.
UR - http://www.scopus.com/inward/record.url?scp=84883691685&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84883691685&partnerID=8YFLogxK
U2 - 10.1210/jc.2013-1584
DO - 10.1210/jc.2013-1584
M3 - Article
C2 - 23969188
AN - SCOPUS:84883691685
SN - 0021-972X
VL - 98
SP - 3702
EP - 3712
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 9
ER -