title: BRAF V600Emutation in prognostication of papillary thyroid cancer (PTC) recurrence.
abstract: Papillary thyroid cancer (PTC) offers excellent prognosis, however relapse risk or persistent disease is related to ~30%. Currently, attention is paid to the possibility of patient group selection of different risk of unfavorable outcome to match a particular therapeutic approach. Therefore, interest in new prognostic and predictive markers known preoperatively is observed.BRAF V600Emutation is such a marker. Many studies analyzing the prevalence of the mutation and its relationship with other clinico-pathological risk factors were reported but with controversial conclusions. The prognostic significance ofBRAFmutation was confirmed by some single centre studies, a few meta-analyses and a large multicenter retrospective international study. They confirmed a correlation between the mutation and the risk of recurrence. The strongest argument against usingBRAFmutation as an independent prognostic and predictive factor in PTC is its high prevalence (30-80%). At present it seems thatBRAFmutation is one of the factors influencing the prognosis and it should be analyzed in correlation with other prognostic factors. The most recent ATA recommendations do not indicate a routine application ofBRAFstatus for initial risk stratification in differentiated thyroid cancer due to a lack of evident confirmation of a direct influence of mutation on the increase in relapse risk. However, ATA demonstrates the continuous risk scale for the relapse risk assessment, consideringBRAFand/orTERTstatus. At present, researchers are working on determining the role ofBRAFmutation in patients from a low-risk group and its correlations with others molecular events. Currently,BRAFmutation cannot be used as a single, independent predictive factor. However, its usefulness in the context of other molecular and clinico-pathological risk factors cannot be excluded. They may be used to make modern prognostic scales of relapse risk and be applied to individualized diagnostic and therapeutic strategy for PTC patients.
authors.affiliation: Department of Oncological and Reconstructive Surgery Center of Oncology, M. Sklodowska-Curie Memorial Institute, Gliwice Branch, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Czarniecka
authors.affiliation: Department of Nuclear Medicine and Endocrine Oncology Center of Oncology, M. Sklodowska-Curie Memorial Institute, Gliwice Branch, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Oczko-Wojciechowska
authors.affiliation: Department of Endocrine Surgery, Third Chair of General Surgery, Jagiellonian University, Medical College, Kraków, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Barczyński
keywords: BRAF V600E mutation; Papillary thyroid cancer (PTC); cancer recurrence; risk-stratification