November 12, 2014
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BRAF V600E mutation increased recurrence risk in papillary thyroid cancer

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Presence of a BRAF V600E mutation appeared to predict recurrence in patients treated for papillary thyroid cancer, according to results of a retrospective, multicenter study.

Researchers evaluated 2,099 patients (1,615 women and 484 men) treated at one of 16 medical centers in eight countries. The mean age of patients was 45 years (interquartile range [IQR], 34-58).

All patients underwent total thyroidectomy, and therapeutic neck dissection was performed when appropriate. The researchers recorded information about patient demographics and papillary thyroid cancer (PTC) stage, and tissue from PTC tumors was sequenced to identify BRAF V600E mutations.

Median follow-up was 36 months (IQR, 14-75).

The researchers determined the overall prevalence of BRAF V600E mutations was 48.5% (n=1,017). PTC recurred in a higher percentage of patients with BRAF V600E mutation-positive patients than BRAF V600E mutation-negative patients (20.9% vs. 11.6%).

Researchers calculated a recurrence rate of 47.71 (95% CI, 41.72-54.58) per 1,000 person-years among patients with BRAF V600E mutations, compared with a recurrence rate of 26.03 (95% CI, 21.85-31.02) per 1,000 person-years among those without the mutation (HR=1.82; 95% CI, 1.46-2.28). The trend persisted in a multivariable model adjusted for patient age and gender, medical center, and various pathological characteristics.

Researchers also observed the correlation between BRAF V600E mutation and recurrence in patients whose PTC generally was considered low risk (stage I or II) and micro-PTC, as well as within various PTC subtypes.

“This was a large multicenter study that provided sufficient power to address the prognostic value of BRAF V600E mutation for the recurrence of PTC in various clinicopathologic categories,” the researchers wrote. “These results, together with the recent demonstration of the strong association of BRAF V600E mutation with PTC-associated patient mortality, help establish a prognostic value of BRAF V600E mutation in PTC.”

Disclosure:  See the full study for a list of the researchers’ relevant financial disclosures.