Null Association between BRAF V600E Mutation and Tumor Recurrence in Patients with Papillary Thyroid Microcarcinoma in South Korea
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Background and Objectives: The clinical implications of the BRAF V600E mutation in papillary thyroid microcarcinoma(PTMC), defined as ≤1.0 cm of tumor size, remain controversial. We investigated the associationbetween the BRAF V600E mutation and PTMC recurrence in a retrospective cohort of patients with thyroid cancer. Materials and Methods: This study included 2319 patients with PTMC (median age, 50 years [interquartile range(IQR), 41-57 years]) who underwent thyroid surgery from 2010 to 2019 at a single tertiary medical center. Themedian follow-up time was 75 months (IQR, 30-98 months). Tumor recurrence was confirmed by histological,cytological, radiographic, and biochemical criteria, combined with persistent and recurrent disease. Results: A totalof 60.2% (1395/2319) patients with PTMC had the BRAF V600E mutation. The tumor recurrence rate was 2.1%(19/924) in BRAF mutation-negative patients and 2.9% (41/1395) in BRAF mutation-positive patients, with ahazard ratio (HR) of 1.05 (95% confidence interval [CI], 0.61-1.84) after adjusting for clinicopathological riskfactors. Similar results were found in patients with high-risk PTMC (adjusted HR, 1.09; 95% CI, 0.56-2.11) whohad lymph node metastasis (LNM), extrathyroidal extension (ETE), or distant metastasis (DM) at diagnosis andin patients with low-risk PTMC (adjusted HR, 1.00; 95% CI, 0.35-2.83) who had no LNM, ETE, or DM. Conclusion:The finding that the BRAF V600E mutation was not associated with tumor recurrence in our cohort of Koreanpatients with PTMC, especially in patients with low-risk PTMC, suggests that its value in the prediction of diseaseprogression is limited.
Abstract
Background and Objectives: The clinical implications of the BRAF V600E mutation in papillary thyroid microcarcinoma(PTMC), defined as ≤1.0 cm of tumor size, remain controversial. We investigated the associationbetween the BRAF V600E mutation and PTMC recurrence in a retrospective cohort of patients with thyroid cancer. Materials and Methods: This study included 2319 patients with PTMC (median age, 50 years [interquartile range(IQR), 41-57 years]) who underwent thyroid surgery from 2010 to 2019 at a single tertiary medical center. Themedian follow-up time was 75 months (IQR, 30-98 months). Tumor recurrence was confirmed by histological,cytological, radiographic, and biochemical criteria, combined with persistent and recurrent disease. Results: A totalof 60.2% (1395/2319) patients with PTMC had the BRAF V600E mutation. The tumor recurrence rate was 2.1%(19/924) in BRAF mutation-negative patients and 2.9% (41/1395) in BRAF mutation-positive patients, with ahazard ratio (HR) of 1.05 (95% confidence interval [CI], 0.61-1.84) after adjusting for clinicopathological riskfactors. Similar results were found in patients with high-risk PTMC (adjusted HR, 1.09; 95% CI, 0.56-2.11) whohad lymph node metastasis (LNM), extrathyroidal extension (ETE), or distant metastasis (DM) at diagnosis andin patients with low-risk PTMC (adjusted HR, 1.00; 95% CI, 0.35-2.83) who had no LNM, ETE, or DM. Conclusion:The finding that the BRAF V600E mutation was not associated with tumor recurrence in our cohort of Koreanpatients with PTMC, especially in patients with low-risk PTMC, suggests that its value in the prediction of diseaseprogression is limited.
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