Does BRAF V600e mutation predict aggressive features in papillary thyroid cancer? results from four endocrine surgery centers

Carol Li, Patricia Aragon Han, Kathleen C. Lee, Louis C. Lee, Amy C. Fox, Toni Beninato, Michele Thiess, Benzon M. Dy, Thomas J. Sebo, Geoffrey B. Thompson, Clive S. Grant, Thomas J. Giordano, Paul G. Gauger, Gerard M. Doherty, Thomas J. Fahey, Justin Bishop, James R. Eshleman, Christopher B. Umbricht, Eric B. Schneider, Martha A. Zeiger

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)3702-3712
Number of pages11
JournalJournal of Clinical Endocrinology and Metabolism
Volume98
Issue number9
DOIs
StatePublished - Sep 2013

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Dissection
Surgery
Mutation
Lymph Node Excision
Lymph Nodes
Neoplasm Metastasis
Tumors
Thyroidectomy
Papillary Thyroid cancer
Neoplasms
Multivariate Analysis
Demography
Prospective Studies

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

Does BRAF V600e mutation predict aggressive features in papillary thyroid cancer? results from four endocrine surgery centers. / Li, Carol; Aragon Han, Patricia; Lee, Kathleen C.; Lee, Louis C.; Fox, Amy C.; Beninato, Toni; Thiess, Michele; Dy, Benzon M.; Sebo, Thomas J.; Thompson, Geoffrey B.; Grant, Clive S.; Giordano, Thomas J.; Gauger, Paul G.; Doherty, Gerard M.; Fahey, Thomas J.; Bishop, Justin; Eshleman, James R.; Umbricht, Christopher B.; Schneider, Eric B.; Zeiger, Martha A.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 98, No. 9, 09.2013, p. 3702-3712.

Research output: Contribution to journalArticle

Li, C, Aragon Han, P, Lee, KC, Lee, LC, Fox, AC, Beninato, T, Thiess, M, Dy, BM, Sebo, TJ, Thompson, GB, Grant, CS, Giordano, TJ, Gauger, PG, Doherty, GM, Fahey, TJ, Bishop, J, Eshleman, JR, Umbricht, CB, Schneider, EB & Zeiger, MA 2013, 'Does BRAF V600e mutation predict aggressive features in papillary thyroid cancer? results from four endocrine surgery centers', Journal of Clinical Endocrinology and Metabolism, vol. 98, no. 9, pp. 3702-3712. https://doi.org/10.1210/jc.2013-1584
Li, Carol ; Aragon Han, Patricia ; Lee, Kathleen C. ; Lee, Louis C. ; Fox, Amy C. ; Beninato, Toni ; Thiess, Michele ; Dy, Benzon M. ; Sebo, Thomas J. ; Thompson, Geoffrey B. ; Grant, Clive S. ; Giordano, Thomas J. ; Gauger, Paul G. ; Doherty, Gerard M. ; Fahey, Thomas J. ; Bishop, Justin ; Eshleman, James R. ; Umbricht, Christopher B. ; Schneider, Eric B. ; Zeiger, Martha A. / Does BRAF V600e mutation predict aggressive features in papillary thyroid cancer? results from four endocrine surgery centers. In: Journal of Clinical Endocrinology and Metabolism. 2013 ; Vol. 98, No. 9. pp. 3702-3712.
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title = "Does BRAF V600e mutation predict aggressive features in papillary thyroid cancer? results from four endocrine surgery centers",
abstract = "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.",
author = "Carol Li and {Aragon Han}, Patricia and Lee, {Kathleen C.} and Lee, {Louis C.} and Fox, {Amy C.} and Toni Beninato and Michele Thiess and Dy, {Benzon M.} and Sebo, {Thomas J.} and Thompson, {Geoffrey B.} and Grant, {Clive S.} and Giordano, {Thomas J.} and Gauger, {Paul G.} and Doherty, {Gerard M.} and Fahey, {Thomas J.} and Justin Bishop and Eshleman, {James R.} and Umbricht, {Christopher B.} and Schneider, {Eric B.} and Zeiger, {Martha A.}",
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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.

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