Seo Ki Kim1, Jun Ho Lee2, Jung-Woo Woo1, Inhye Park1, Jun-Ho Choe1, Jung-Han Kim1, Jee Soo Kim1. 1. Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. 2. Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea.
Abstract
BACKGROUND: The necessity of prophylactic central neck dissection is one of debating issues in the treatment of papillary thyroid carcinoma (PTC). In a previous study, the predictive value of BRAF mutation for lymph node metastasis was only significant in 0.5 to 1.0 cm PTC. Thus, we assess the predictive value of BRAF mutation for central lymph node metastasis according to tumor size. METHODS: Medical records of 3107 patients with PTC who underwent thyroidectomy with central neck dissection were retrospectively reviewed. RESULTS: BRAF mutation was a predictor for central lymph node metastasis in 2.0 to 4.0 cm PTC (odds ratio [OR] = 3.494; p = .002). Although BRAF mutation was associated with central lymph node metastasis in 0.5 to 1.0 cm PTC in univariate analysis (OR = 1.334; p = .047), this significance was not observed in multivariate analysis (OR = 1.232; p = .163). BRAF mutation was not associated with central lymph node metastasis in other tumor sizes. CONCLUSION: Prophylactic central neck dissection could be considered in 2.0 to 4.0 cm PTC with positive BRAF mutation.
BACKGROUND: The necessity of prophylactic central neck dissection is one of debating issues in the treatment of papillary thyroid carcinoma (PTC). In a previous study, the predictive value of BRAF mutation for lymph node metastasis was only significant in 0.5 to 1.0 cm PTC. Thus, we assess the predictive value of BRAF mutation for central lymph node metastasis according to tumor size. METHODS: Medical records of 3107 patients with PTC who underwent thyroidectomy with central neck dissection were retrospectively reviewed. RESULTS:BRAF mutation was a predictor for central lymph node metastasis in 2.0 to 4.0 cm PTC (odds ratio [OR] = 3.494; p = .002). Although BRAF mutation was associated with central lymph node metastasis in 0.5 to 1.0 cm PTC in univariate analysis (OR = 1.334; p = .047), this significance was not observed in multivariate analysis (OR = 1.232; p = .163). BRAF mutation was not associated with central lymph node metastasis in other tumor sizes. CONCLUSION: Prophylactic central neck dissection could be considered in 2.0 to 4.0 cm PTC with positive BRAF mutation.
Authors: Carrie C Lubitz; Tiannan Zhan; Viswanath Gunda; Salma Amin; Benjamin J Gigliotti; Abbey L Fingeret; Tammy M Holm; Heather Wachtel; Peter M Sadow; Lori J Wirth; Ryan J Sullivan; David J Panka; Sareh Parangi Journal: Thyroid Date: 2018-02-27 Impact factor: 6.568