BRAFV600E Mutation is Associated with an Increased Risk of Papillary Thyroid Cancer Recurrence

Background Papillary thyroid carcinoma is the most common endocrine malignancy and one of the most common cancers worldwide. However, the optimal timing and frequency of surveillance to assess for recurrence remain undetermined. As the incidence of thyroid cancer continues to rise worldwide, identif...

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Published inWorld journal of surgery Vol. 44; no. 8; pp. 2685 - 2691
Main Authors Enumah, Samuel, Fingeret, Abbey, Parangi, Sareh, Dias-Santagata, Dora, Sadow, Peter M., Lubitz, Carrie C.
Format Journal Article
LanguageEnglish
Published Cham Springer International Publishing 01.08.2020
Springer Nature B.V
Subjects
Abdominal Surgery
Cancer
Cardiac Surgery
General Surgery
Genotyping
Health risks
Malignancy
Medicine
Medicine & Public Health
Mutation
Original Scientific Report
Papillary thyroid cancer
Papillary thyroid carcinoma
Risk analysis
Risk factors
Risk groups
Surgery
Surveillance
Thoracic Surgery
Thyroid
Thyroid cancer
Thyroid gland
Thyroidectomy
Vascular Surgery
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Summary:Background Papillary thyroid carcinoma is the most common endocrine malignancy and one of the most common cancers worldwide. However, the optimal timing and frequency of surveillance to assess for recurrence remain undetermined. As the incidence of thyroid cancer continues to rise worldwide, identifying risk factors for recurrence and investigating intervals and durations of surveillance are paramount to adapt treatment and follow-up plans to high-risk individuals and to reduce interventions for low-risk patients. Methods Our dataset included an unselected cohort of papillary thyroid carcinoma (PTC) patients who underwent a total thyroidectomy (or unilateral then completion thyroidectomy) at a single institution from 2000 to 2007. BRAF genotyping was performed on available specimens by a validated PCR-based assay. Pathologic structural recurrence was the primary outcome. We performed univariate and multivariable analyses to identify predictors of cancer recurrence. Results In total, 599 patients underwent complete resection of the thyroid gland for PTC. The cohort was young (mean age 45.0 years), predominately female ( n  = 462, 76.9%), and median follow-up was 10.3 years (IQR 5.4–12.2). Recurrence occurred more commonly in the BRAF V600E group (18.6 vs. 9.9%, p  = 0.02). BRAF independently predicted PTC recurrence (HR 2.81, p  = 0.006). Conclusions BRAF mutation is an independent predictor of papillary thyroid carcinoma long-term recurrence. Understanding molecular characteristics of individual thyroid cancers may help risk-stratify patients and direct them toward more appropriate initial care and long-term surveillance strategies.
Bibliography:An abstract based on the data found in the manuscript was presented at the Academic Surgical Congress in 2016.
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Author contributions SE had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. CCL, AF, and SE contributed to the study concept and design. All authors performed the acquisition, analysis, or interpretation of data. SE and CL drafted the manuscript. All authors critically revised the manuscript for important intellectual content. SE and CCL carried out statistical analysis. CCL obtained funding. All authors provided administrative, technical, or material support. CCL supervised the study.
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-020-05521-2