Faculty Collaboration Database

BRAF(V600E) Is Correlated with Recurrence of Papillary Thyroid Microcarcinoma: A Systematic Review, Multi-Institutional Primary Data Analysis, and Meta-Analysis. Thyroid 2016 Feb;26(2):248-55

Date

12/17/2015

Pubmed ID

26671072

DOI

10.1089/thy.2015.0391

Scopus ID

2-s2.0-84958035683 (requires institutional sign-in at Scopus site)   82 Citations

Abstract

BACKGROUND: Given the increasing incidence of papillary thyroid carcinoma despite stable disease-specific mortality rates, the potential for the disease to reoccur is a key outcome to predict. The BRAF(V600E) mutation has been associated with recurrent disease in larger tumors. However, its correlation in papillary thyroid microcarcinoma (PTMC) is not clear in individual series.

METHODS: The MEDLINE, EMBASE, Web of Science, and Cochrane databases were searched for studies including patients with PTMC undergoing initial surgical treatment. Studies with at least two years of follow-up, BRAF genotyping (the comparator), and recurrence as an outcome were included, as were unpublished primary data on 485 patients from two institutions. The metameter analyzed was odds ratio (OR) for recurrence between patients with BRAF(V600E) versus BRAF wild type (BRAFwt).

RESULTS: The initial search identified 431 references. After screening of the abstracts for inclusion, 44 manuscripts were reviewed in full by two independent reviewers. Four published studies and primary data from two institutional cohorts were included in the final analysis. A meta-analysis of 2247 PTMC patients revealed that patients with a BRAF(V600E) mutation had a higher likelihood for recurrence (odds ratio 2.09 [confidence interval 1.31-3.33], p = 0.002).

CONCLUSIONS: This meta-analysis shows that BRAF mutational status correlates with recurrence of PTMCs, highlighting the potential utility of genotyping in preoperative and postoperative planning. BRAF mutation may be helpful in risk-stratifying patients with PTMC for surgical management versus observation.

Author List

Chen Y, Sadow PM, Suh H, Lee KE, Choi JY, Suh YJ, Wang TS, Lubitz CC

Author

Tracy S. Wang MD, MPH Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Carcinoma, Papillary
Cohort Studies
DNA Mutational Analysis
Female
Genotype
Humans
Male
Middle Aged
Mutation
Neoplasm Recurrence, Local
Proto-Oncogene Proteins B-raf
Risk Assessment
Thyroid Neoplasms