DoesBRAFV600E Mutation Predict Aggressive Features in Papillary Thyroid Cancer? Results From Four Endocrine Surgery Centers

Abstract

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.

Association of BRAFV600E Mutation and MicroRNA Expression with Central Lymph Node Metastases in Papillary Thyroid Cancer: A Prospective Study from Four Endocrine Surgery Centers

“…The tall-cell variant of PTC (TCVPTC) has the highest prevalence at 93% (15), followed by classical variant of PTC (CVPTC), comprising up to 75.3% (11), and lastly, follicular variant of PTC (FVPTC) at only 25% (16). Some studies have shown that the BRAF V600E mutation is associated with aggressive clinicopathologic features, such as extrathyroidal invasion, multifocality, lymphovascular invasion, large tumor size, local lymph node metastasis, distant metastasis, and advanced disease stages (17)(18)(19)(20)(21)(22), whereas others studies have demonstrated no association between the BRAF V600E mutation and aggressive features (23)(24)(25)(26)(27)(28)(29)(30). In a previous retrospective study, the BRAF V600E mutation was found to be an independent predictor of CLNM in the overall cohort of patients with PTC (23).…”

“…In a previous retrospective study, the BRAF V600E mutation was found to be an independent predictor of CLNM in the overall cohort of patients with PTC (23). However, this relationship lost significance when only CVPTC was included in the analysis (23). Despite the discrepancies that exist in the literature, some studies have suggested the incorporation of BRAF V600E mutation into the management algorithm of PTC to improve perioperative decision making (9,17,18,20,22).…”

“…Despite the discrepancies that exist in the literature, some studies have suggested the incorporation of BRAF V600E mutation into the management algorithm of PTC to improve perioperative decision making (9,17,18,20,22). However, the usefulness of BRAF V600E in predicting the presence of LNM remains questionable (23,31).…”

BRAF mutation assessment in papillary thyroid cancer: are we ready to use it in clinical practice?

“…Accordingly, a positive BRAF mutation status has been considered a reliable factor to guide prophylactic central neck lymph node dissection, although routine application of this practice in the absence of prospective studies has been recently questioned [16]. Moreover, BRAF mutation status has been hypothesized to be useful in defining necessity to perform radioiodine ablation in low risk patients, targets of TSH suppression, intensity of recurrence surveillance, and threshold of FDG-PET execution.…”

RAS/BRAF mutational status in familial non-medullary thyroid carcinomas: A retrospective study

“…By contrast, BRAF/RAS wild type tumors presented an increased frequency of associated thyroiditis, suggesting that thyroiditis is not a feature associated with nor responsible for the unfavorable prognostic profile of these tumors. Indeed, the present data must be taken with caution and should be interpreted in the perspective of the unsolved controversy on whether BRAF and NRAS mutations are prognostic in sporadic thyroid carcinomas (28)(29)(30)(31). However, the present genetic profiling suggests that the mutational status of specific genes deserves to be further and more extensively evaluated in FNMTCs, since it may aid in the identification of those tumors with a more aggressive clinical phenotype.…”