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BRAF V600E mutation independently predicts central compartment lymph node metastasis in patients with papillary thyroid cancer.

Publication ,  Journal Article
Howell, GM; Nikiforova, MN; Carty, SE; Armstrong, MJ; Hodak, SP; Stang, MT; McCoy, KL; Nikiforov, YE; Yip, L
Published in: Ann Surg Oncol
January 2013

PURPOSE: This study was designed to examine whether available preoperative clinical parameters, including B-type Raf kinase (BRAF) V600E mutation status, can identify patients at risk for central compartment lymph node metastasis (CLNM). METHODS: Under an institutional review board-approved protocol, we conducted a single-center, retrospective review of all patients who had initial thyroidectomy for histologic papillary thyroid carcinoma (PTC) during 2010. The presence of CLNM was examined for correlation with available preoperative clinical parameters, including tumor size, gender, age, and BRAF mutation status. RESULTS: Cervical lymph node resection and molecular testing on FNAB or histopathologic specimen was performed on a consecutive series of 156 study patients with histologic PTC. Overall, CLNM was diagnosed in 37% and 46% were BRAF-mutation-positive. BRAF positivity was the only clinical parameter associated with CLNM (BRAF, p=0.002; tumor size≥2 cm, p=0.16; male gender, p=0.1; age≥45 years, p=0.3) and remained an independent predictor of CLNM on multiple logistic regression analysis (odds ratio (OR) 3.2, p=0.001). The PPV and NPV of BRAF positivity for CLNM was 50 and 74%, respectively. When restricting the analysis to the subset of 38 patients who had molecular testing performed preoperatively on FNAB, the PPV and NPV of BRAF positivity for CLNM was 47 and 91%, respectively, and BRAF positivity was still a significant predictor of CLNM on both univariate (OR 8.4, p=0.01) and multivariate (OR 9.7, p=0.02) analyses. CONCLUSIONS: Of the commonly used clinical parameters available preoperatively, the BRAF V600E mutation is the only independent predictor of CLNM in PTC and can be utilized to guide the extent of initial surgery.

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Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

January 2013

Volume

20

Issue

1

Start / End Page

47 / 52

Location

United States

Related Subject Headings

  • Thyroid Neoplasms
  • Retrospective Studies
  • Proto-Oncogene Proteins B-raf
  • Predictive Value of Tests
  • Oncology & Carcinogenesis
  • Odds Ratio
  • Neck Dissection
  • Mutation
  • Multivariate Analysis
  • Middle Aged
 

Citation

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Howell, G. M., Nikiforova, M. N., Carty, S. E., Armstrong, M. J., Hodak, S. P., Stang, M. T., … Yip, L. (2013). BRAF V600E mutation independently predicts central compartment lymph node metastasis in patients with papillary thyroid cancer. Ann Surg Oncol, 20(1), 47–52. https://doi.org/10.1245/s10434-012-2611-0
Howell, Gina M., Marina N. Nikiforova, Sally E. Carty, Michaele J. Armstrong, Steven P. Hodak, Michael T. Stang, Kelly L. McCoy, Yuri E. Nikiforov, and Linwah Yip. “BRAF V600E mutation independently predicts central compartment lymph node metastasis in patients with papillary thyroid cancer.Ann Surg Oncol 20, no. 1 (January 2013): 47–52. https://doi.org/10.1245/s10434-012-2611-0.
Howell GM, Nikiforova MN, Carty SE, Armstrong MJ, Hodak SP, Stang MT, et al. BRAF V600E mutation independently predicts central compartment lymph node metastasis in patients with papillary thyroid cancer. Ann Surg Oncol. 2013 Jan;20(1):47–52.
Howell, Gina M., et al. “BRAF V600E mutation independently predicts central compartment lymph node metastasis in patients with papillary thyroid cancer.Ann Surg Oncol, vol. 20, no. 1, Jan. 2013, pp. 47–52. Pubmed, doi:10.1245/s10434-012-2611-0.
Howell GM, Nikiforova MN, Carty SE, Armstrong MJ, Hodak SP, Stang MT, McCoy KL, Nikiforov YE, Yip L. BRAF V600E mutation independently predicts central compartment lymph node metastasis in patients with papillary thyroid cancer. Ann Surg Oncol. 2013 Jan;20(1):47–52.
Journal cover image

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

January 2013

Volume

20

Issue

1

Start / End Page

47 / 52

Location

United States

Related Subject Headings

  • Thyroid Neoplasms
  • Retrospective Studies
  • Proto-Oncogene Proteins B-raf
  • Predictive Value of Tests
  • Oncology & Carcinogenesis
  • Odds Ratio
  • Neck Dissection
  • Mutation
  • Multivariate Analysis
  • Middle Aged