title: Progression of solitary and multifocal papillary thyroid carcinoma - a retrospective study of 368 patients.
abstract: BACKGROUND
  Papillary thyroid carcinoma (PTC) represents one of the most frequent endocrine malignancies. Several factors have been found to be involved in determining the outcome of treatment for patients with PTC. Large tumor size, diagnosis at an early age, extra-thyroidal invasion, aggressive histological variants, and distant metastases are the most important determinants of a poor outcome. BRAF(V600E) mutation has been found to be a major genetic alteration in PTC. This study aimed to evaluate progression in patients with multifocal and solitary PTC.
  
  
  METHODS
  We performed a retrospective study to analyze 368 patients with PTC who underwent surgery, including 282 patients with solitary PTC and 86 patients with multifocal PTC. The status of BRAF(V600E) mutation in all tumor foci from multifocal PTC was detected.
  
  
  RESULTS
  Our study suggested that multifocal PTC was more related to lymph node metastasis and vascular invasion than solitary PTC. However, the distant metastasis rate and 10-year survival rate showed no difference between these two groups. The number of tumor foci did not affect progression of disease in multifocal PTC patients. Lymph node metastasis in multifocal PTC patients was associated with larger tumors, diagnosis at early stage, and extra-thyroidal invasion.
  
  
  CONCLUSIONS
  The status of BRAF(V600E) mutation was more frequent in multifocal PTC patients with lymph node metastasis and diagnosis at later age.
authors.affiliation: Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, China.
authors.forename: Xiang-qian
authors.initials: XQ
authors.lastname: Zheng
authors.forename: Chen
authors.initials: C
authors.lastname: Wang
authors.forename: Meng
authors.initials: M
authors.lastname: Xu
authors.forename: Yang
authors.initials: Y
authors.lastname: Yu
authors.forename: Xin-wei
authors.initials: XW
authors.lastname: Yun
authors.forename: Yong-sheng
authors.initials: YS
authors.lastname: Jia
authors.forename: Song-feng
authors.initials: SF
authors.lastname: Wei
authors.forename: Xiu-bao
authors.initials: XB
authors.lastname: Ren
authors.forename: Ming
authors.initials: M
authors.lastname: Gao
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000235:genetics* / Q000473:pathology*; D002291:Carcinoma, Papillary / Q000235:genetics* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000235:genetics* / Q000473:pathology*
chemical_list: C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf