title: Both BRAF V600E mutation and older age (≥ 65 years) are associated with recurrent papillary thyroid cancer.
abstract: OBJECTIVE
  This study was designed to examine the aggressive features of BRAF-positive papillary thyroid cancer (PTC) and association with age.
  
  
  METHODS
  We compared the clinicopathologic parameters and BRAF V600E mutation status of 121 elderly (age ≥65 years) PTC patients who underwent thyroidectomy from January 2007 to December 2009 to a consecutive cohort of 98 younger (age <65 years) PTC patients.
  
  
  RESULTS
  Younger and elderly PTC patients had similar incidences of BRAF-positive tumors (41% vs. 38%; p = 0.67). The elderly cohort was more likely to have smaller tumors (mean 1.6 vs. 2.1 cm; p = 0.001), present with advanced TNM stage (36% vs. 19%; p = 0.008), and have persistent/recurrent disease (10% vs. 1%; p = 0.006). BRAF-positive status was associated with PTC that were tall cell variant (p < 0.001), had extrathyroidal extension (p < 0.001), lymph node involvement (p = 0.008), advanced (III/IV) TNM stage (p < 0.001), and disease recurrence (p < 0.001). Except for lymph node involvement, the association between aggressive histology characteristics at presentation and BRAF-positive PTC also was observed within the age-defined cohorts. In short-term follow-up (mean, 18 months), persistent/recurrent PTC was much more likely to occur in patients who were both BRAF-positive and elderly (22%).
  
  
  CONCLUSIONS
  BRAF mutations are equally present in younger and older patients. Aggressive histology characteristics at presentation are associated with BRAF-positive PTC, irrespective of age. However, the well-established association of BRAF with recurrence is limited to older (age ≥65 years) patients.
authors: Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
authors: Gina M
authors: GM
authors: Howell
authors: Sally E
authors: SE
authors: Carty
authors: Michaele J
authors: MJ
authors: Armstrong
authors: Shane O
authors: SO
authors: Lebeau
authors: Steven P
authors: SP
authors: Hodak
authors: Christopher
authors: C
authors: Coyne
authors: Michael T
authors: MT
authors: Stang
authors: Kelly L
authors: KL
authors: McCoy
authors: Marina N
authors: MN
authors: Nikiforova
authors: Yuri E
authors: YE
authors: Nikiforov
authors: Linwah
authors: L
authors: Yip