Int J Thyroidol.  2021 Nov;14(2):135-142. 10.11106/ijt.2021.14.2.135.

Null Association between BRAF V600E Mutation and Tumor Recurrence in Patients with Papillary Thyroid Microcarcinoma in South Korea

• Kim JY
• Kim KJ
• Bae JH
• Kim JH
• Kim NH
• Kim HY
• Kim HY
• Baek SK
• Kim SG
• Jung KY
• Kim KJ

• KMID: 2522918
• DOI: http://doi.org/10.11106/ijt.2021.14.2.135

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 association between the BRAFV600E 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. The median 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 total of 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 a hazard ratio (HR) of 1.05 (95% confidence interval [CI], 0.61-1.84) after adjusting for clinicopathological risk factors. Similar results were found in patients with high-risk PTMC (adjusted HR, 1.09; 95% CI, 0.56-2.11) who had lymph node metastasis (LNM), extrathyroidal extension (ETE), or distant metastasis (DM) at diagnosis and in 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 Korean patients with PTMC, especially in patients with low-risk PTMC, suggests that its value in the prediction of disease progression is limited.

Keyword

Papillary thyroid microcarcinoma; BRAF V600E mutation; Active surveillance; Tumor recurrence

Figure

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  Fig. 1 Flow diagram of the study subject selection process.

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  Fig. 2 Kaplan–Meier analysis of disease recurrence-free survival based on BRAF V600E mutation status in papillary thyroid microcarcinoma (PTMC). (A) All types of PTMC. (B) Low-risk PTMC. (C) High-risk PTMC. Follow-up time is truncated to 132 months.

Reference

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