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 patients who underwent 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.
  
  
  CONCLUSIONS
  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.
authors: Endocrine Surgery, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
authors: Carol
authors: C
authors: Li
authors: Patricia
authors: P
authors: Aragon Han
authors: Kathleen C
authors: KC
authors: Lee
authors: Louis C
authors: LC
authors: Lee
authors: Amy C
authors: AC
authors: Fox
authors: Toni
authors: T
authors: Beninato
authors: Michele
authors: M
authors: Thiess
authors: Benzon M
authors: BM
authors: Dy
authors: Thomas J
authors: TJ
authors: Sebo
authors: Geoffrey B
authors: GB
authors: Thompson
authors: Clive S
authors: CS
authors: Grant
authors: Thomas J
authors: TJ
authors: Giordano
authors: Paul G
authors: PG
authors: Gauger
authors: Gerard M
authors: GM
authors: Doherty
authors: Thomas J
authors: TJ
authors: Fahey
authors: Justin
authors: J
authors: Bishop
authors: James R
authors: JR
authors: Eshleman
authors: Christopher B
authors: CB
authors: Umbricht
authors: Eric B
authors: EB
authors: Schneider
authors: Martha A
authors: MA
authors: Zeiger
mesh_terms: D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000235:genetics / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*; D013964:Thyroid Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy
chemical_list: C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf