At total of 431 articles were initially screened, but only 4 met criteria for inclusion. These inclusion criteria were papillary thyroid cancer less than 10mm in size, BRAFV600E studies, documentation of clinical remission, and at least 2 years of follow-up. Also, 2 unpublished series were added to the analysis. The sample size of the combined series was 2247 patients (average age of 45-50, 77-88% women) from 6 different datasets of patients. BRAFV600E rate was 40-69% of the patients depending upon the series, with recurrence rates of 10.0% in the BRAF+ group and 4.5% in the BRAF negative group. BRAFV600E mutation status was directly correlated this ~2-fold increase in the rate of recurrence.
WHAT ARE THE IMPLICATIONS OF THIS STUDY?
This study suggests that the presence of the BRAFV600E mutation is correlated with recurrence or papillary microcancers. If this indeed is true, initial treatment could then be tailored to reduce recurrence in higher risk patients, sparing low risk patients from potential side effects of therapy. Prospective trials from the time of nodule evaluation through long-term follow-up will be helpful in confirming the whether the BRAFV600E mutation analysis can predict cancer recurrence.
— Julie Hallanger Johnson, MD
ATA THYROID BROCHURE LINKS
Thyroid Cancer: http://www.thyroid.org/thyroid-cancer/