Both BRAF V600E Mutation and Older Age (≥65 Years) are Associated with Recurrent Papillary Thyroid Cancer
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This study was designed to examine the aggressive features of BRAF-positive papillary thyroid cancer (PTC) and association with age.
We compared the clinicopathologic parameters and BRAF V600E mutation status of 121 elderly (age ≥65 years) PTC patients who underwent thyroidectomy from January 2007 to December 2009 to a consecutive cohort of 98 younger (age <65 years) PTC patients.
Younger and elderly PTC patients had similar incidences of BRAF-positive tumors (41% vs. 38%; p = 0.67). The elderly cohort was more likely to have smaller tumors (mean 1.6 vs. 2.1 cm; p = 0.001), present with advanced TNM stage (36% vs. 19%; p = 0.008), and have persistent/recurrent disease (10% vs. 1%; p = 0.006). BRAF-positive status was associated with PTC that were tall cell variant (p < 0.001), had extrathyroidal extension (p < 0.001), lymph node involvement (p = 0.008), advanced (III/IV) TNM stage (p < 0.001), and disease recurrence (p < 0.001). Except for lymph node involvement, the association between aggressive histology characteristics at presentation and BRAF-positive PTC also was observed within the age-defined cohorts. In short-term follow-up (mean, 18 months), persistent/recurrent PTC was much more likely to occur in patients who were both BRAF-positive and elderly (22%).
BRAF mutations are equally present in younger and older patients. Aggressive histology characteristics at presentation are associated with BRAF-positive PTC, irrespective of age. However, the well-established association of BRAF with recurrence is limited to older (age ≥65 years) patients.
KeywordsPapillary Thyroid Carcinoma BRAF Mutation Papillary Thyroid Carcinoma BRAF V600E Mutation Extrathyroidal Extension
- 17.American Thyroid Association Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer. Revised American Thyroid Association guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19:1167–214.Google Scholar
- 19.Surveillance, Epidemiology and End Results (SEER) Program of the National Cancer Institute. J Natl Cancer Inst. 1997;89:1753.Google Scholar
- 20.Greene FL, Page DL, Fleming ID, et al., editors. Thyroid. In: American Joint Committee on Cancer: cancer staging manual, 6th edn. New York: Springer; 2002. p. 77–87.Google Scholar
- 21.Riesco-Eizaguirre G, Gutierrez-Martinez P, Garcia-Cabezas MA, et al. The oncogene BRAF V600E is associated with a high risk of recurrence and less differentiated papillary thyroid carcinoma due to the impairment of Na+/I targeting to the membrane. Endocr Relat Cancer. 2006;13:257–69.PubMedCrossRefGoogle Scholar