Thursday, May 8, 2014

BRAF V600E mutation did not independently predict thyroid cancer recurrence, persistence | Hematology Oncology

Russo M. Thyroid. 2014;doi:10.1089/thy.2013.0675.

  • May 7, 2014
Patients with BRAF V600E-mutated papillary thyroid cancer demonstrated more aggressive disease, but the mutation was not an independent prognostic factor for inferior outcomes, according to study results.
The analysis included 103 patients with classical variant papillary thyroid cancer who underwent total thyroidectomy between 2005 and 2008. Most patients were female (n=86), and the median age of patients at the time of diagnosis was 45 years (range, 15.2-78.2).
Mean follow-up was 55 months (range, 42-68).
Fifty-seven patients (55.3%) harbored aBRAF V600E mutation. Univariate analyses indicated these patients were more likely to have lymph node metastases at the time of diagnosis (P=.01), TNM stage III or IV (P=.03), and recurrent or persistent disease at follow-up (P=.03).
However, multivariate analyses indicated only lymph node metastases were significantly more common in BRAF V600E-mutated disease (OR=2.9; 95% CI, 1.1-7.3).
Patients with BRAF V600E mutations demonstrated a significantly increased risk for recurrence (OR=5.8; 95% CI, 1.2-27.9) and persistent disease at last visit (OR=3.5; 95% CI, 1.2-10.3). However, only lymph node metastases independently predicted persistent disease (OR=30.9; 95% CI, 6-159).
A Kaplan-Meier analysis also indicated BRAF V600E mutation status did not impact the risk for recurrence among patients with two or more risk factors (P=.2).
“The current evidence does not support the cost-effectiveness of the qualitative detection of BRAF V600E mutation in clinical practice,” the researchers wrote. “At present, the determination of the BRAF V600Emutation status should be considered among the many markers that indicate a high risk of more aggressive papillary thyroid cancer biology, although this is not true for all BRAF V600E-positive papillary thyroid cancers.”
Disclosure: The researchers report no relevant financial disclosures.

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