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BRAF V600E Status Sharply Differentiates Lymph Node Metastasis-associated Mortality Risk in Papillary Thyroid Cancer.

Yubing Tao1, Fei Wang1,2, Xiaopei Shen2

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The Journal of Clinical Endocrinology and Metabolism
|July 17, 2021
PubMed
Summary

Lymph node metastasis (LNM) significantly increases mortality risk in papillary thyroid cancer (PTC) with BRAF V600E mutations. LNM poses no significant mortality risk in PTC patients with wild-type BRAF.

Keywords:
BRAF mutationlymph node metastasismortalityprognostic molecular markerrisk stratificationthyroid cancer

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Area of Science:

  • Oncology
  • Genetics
  • Pathology

Background:

  • Papillary thyroid cancer (PTC) is the most common thyroid malignancy.
  • The prognostic role of lymph node metastasis (LNM) and BRAF V600E mutations in PTC mortality is not fully understood.
  • Understanding these factors is crucial for risk stratification and treatment decisions.

Purpose of the Study:

  • To investigate the impact of BRAF V600E mutations on the association between lymph node metastasis (LNM) and mortality risk in papillary thyroid cancer (PTC).
  • To determine if LNM-associated mortality differs between PTC patients with and without the BRAF V600E mutation.

Main Methods:

  • Retrospective analysis of 2638 PTC patients from 11 centers across 6 countries.
  • Evaluation of LNM status and BRAF V600E mutation status in relation to PTC-specific mortality.
  • Statistical analysis including multivariate adjustment and Kaplan-Meier survival analyses.

Main Results:

  • Lymph node metastasis (LNM) was associated with a modest mortality risk in patients with wild-type BRAF.
  • LNM demonstrated a strong mortality risk in patients with the BRAF V600E mutation.
  • The combined presence of LNM and BRAF V600E mutation showed a significantly synergistic increase in mortality risk.

Conclusions:

  • Lymph node metastasis (LNM) significantly elevates mortality risk in papillary thyroid cancer (PTC) patients with BRAF V600E mutations.
  • In conventional PTC (CPTC), LNM does not increase mortality risk in patients with wild-type BRAF but robustly increases it in those with BRAF mutations.
  • These findings highlight the critical role of BRAF status in determining the clinical significance of LNM in PTC.