Samuel Enumah1, Abbey Fingeret2, Sareh Parangi3, Dora Dias-Santagata4, Peter M Sadow5, Carrie C Lubitz6. 1. Brigham and Women's Hospital, 75 Francis St. CA-034, Boston, MA, 02115, USA. 2. University of Nebraska Medical Center, Omaha, NE, 68198, USA. 3. Harvard Medical School, Massachusetts General Hospital, 55 Fruit St, Wang Ambulatory Center 460, Boston, MA, 02114, USA. 4. Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, GRJ222, Boston, MA, 02114, USA. 5. Harvard Medical School, Massachusetts General Hospital, 55 Fruits Street, WRN219, Boston, MA, 02114, USA. 6. Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, YAW 7B, Boston, MA, 02114, USA. CLUBITZ@mgh.harvard.edu.
Abstract
BACKGROUND: Papillary thyroid carcinoma is the most common endocrine malignancy and one of the most common cancers worldwide. However, the optimal timing and frequency of surveillance to assess for recurrence remain undetermined. As the incidence of thyroid cancer continues to rise worldwide, identifying risk factors for recurrence and investigating intervals and durations of surveillance are paramount to adapt treatment and follow-up plans to high-risk individuals and to reduce interventions for low-risk patients. METHODS: Our dataset included an unselected cohort of papillary thyroid carcinoma (PTC) patients who underwent a total thyroidectomy (or unilateral then completion thyroidectomy) at a single institution from 2000 to 2007. BRAF genotyping was performed on available specimens by a validated PCR-based assay. Pathologic structural recurrence was the primary outcome. We performed univariate and multivariable analyses to identify predictors of cancer recurrence. RESULTS: In total, 599 patients underwent complete resection of the thyroid gland for PTC. The cohort was young (mean age 45.0 years), predominately female (n = 462, 76.9%), and median follow-up was 10.3 years (IQR 5.4-12.2). Recurrence occurred more commonly in the BRAFV600E group (18.6 vs. 9.9%, p = 0.02). BRAF independently predicted PTC recurrence (HR 2.81, p = 0.006). CONCLUSIONS: BRAF mutation is an independent predictor of papillary thyroid carcinoma long-term recurrence. Understanding molecular characteristics of individual thyroid cancers may help risk-stratify patients and direct them toward more appropriate initial care and long-term surveillance strategies.
BACKGROUND:Papillary thyroid carcinoma is the most common endocrine malignancy and one of the most common cancers worldwide. However, the optimal timing and frequency of surveillance to assess for recurrence remain undetermined. As the incidence of thyroid cancer continues to rise worldwide, identifying risk factors for recurrence and investigating intervals and durations of surveillance are paramount to adapt treatment and follow-up plans to high-risk individuals and to reduce interventions for low-risk patients. METHODS: Our dataset included an unselected cohort of papillary thyroid carcinoma (PTC) patients who underwent a total thyroidectomy (or unilateral then completion thyroidectomy) at a single institution from 2000 to 2007. BRAF genotyping was performed on available specimens by a validated PCR-based assay. Pathologic structural recurrence was the primary outcome. We performed univariate and multivariable analyses to identify predictors of cancer recurrence. RESULTS: In total, 599 patients underwent complete resection of the thyroid gland for PTC. The cohort was young (mean age 45.0 years), predominately female (n = 462, 76.9%), and median follow-up was 10.3 years (IQR 5.4-12.2). Recurrence occurred more commonly in the BRAFV600E group (18.6 vs. 9.9%, p = 0.02). BRAF independently predicted PTC recurrence (HR 2.81, p = 0.006). CONCLUSIONS:BRAF mutation is an independent predictor of papillary thyroid carcinoma long-term recurrence. Understanding molecular characteristics of individual thyroid cancers may help risk-stratify patients and direct them toward more appropriate initial care and long-term surveillance strategies.
Authors: Abdul K Siraj; Sandeep Kumar Parvathareddy; Padmanaban Annaiyappanaidu; Nabil Siraj; Saif S Al-Sobhi; Fouad Al-Dayel; Khawla S Al-Kuraya Journal: Front Endocrinol (Lausanne) Date: 2022-03-10 Impact factor: 5.555
Authors: Afaf T Ibrahiem; Amin K Makhdoom; Khalid S Alanazi; Abdulaziz M Alanazi; Abdulaziz M Mukhlef; Saad H Elshafey; Eman A Toraih; Manal S Fawzy Journal: J Clin Lab Anal Date: 2022-04-07 Impact factor: 3.124