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Annals of Surgical Oncology

, Volume 18, Issue 13, pp 3566–3571 | Cite as

Both BRAF V600E Mutation and Older Age (≥65 Years) are Associated with Recurrent Papillary Thyroid Cancer

  • Gina M. Howell
  • Sally E. Carty
  • Michaele J. Armstrong
  • Shane O. LeBeau
  • Steven P. Hodak
  • Christopher Coyne
  • Michael T. Stang
  • Kelly L. McCoy
  • Marina N. Nikiforova
  • Yuri E. Nikiforov
  • Linwah Yip
Endocrine Tumors

Abstract

Purpose

This study was designed to examine the aggressive features of BRAF-positive papillary thyroid cancer (PTC) and association with age.

Methods

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.

Results

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%).

Conclusions

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.

Keywords

Papillary Thyroid Carcinoma BRAF Mutation Papillary Thyroid Carcinoma BRAF V600E Mutation Extrathyroidal Extension 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Gina M. Howell
    • 1
  • Sally E. Carty
    • 1
  • Michaele J. Armstrong
    • 1
  • Shane O. LeBeau
    • 2
  • Steven P. Hodak
    • 2
  • Christopher Coyne
    • 2
  • Michael T. Stang
    • 1
  • Kelly L. McCoy
    • 1
  • Marina N. Nikiforova
    • 3
  • Yuri E. Nikiforov
    • 3
  • Linwah Yip
    • 1
  1. 1.Department of SurgeryUniversity of PittsburghPittsburghUSA
  2. 2.Department of EndocrinologyUniversity of PittsburghPittsburghUSA
  3. 3.Department of PathologyUniversity of PittsburghPittsburghUSA

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