Thyroid cancer is the fastest rising cancer in women. The approach to the management of thyroid cancer currently is based on the risk of the thyroid cancer persisting or recurring after initial treatment. This is especially important in low risk thyroid cancers, which are the most common and fastest rising. Recent availability of testing for gene mutations in thyroid biopsy specimens, so-called molecular markers, has provided insight to the prognosis of some thyroid cancers and also to the cause of the cancers. This can allow the identification of cancers that are at high risk vs low risk for spreading outside the thyroid. Already, molecular markers have been helpful in identifying a variant of papillary cancer that may not be a cancer after all. Finally, these molecular markers may be used to determine effective treatment approaches.
This study uses molecular markers to determine both prognosis of papillary cancer and the importance of papillary cancer spreading to the lymph nodes of the neck.
THE FULL ARTICLE TITLE:
Ren H et al 2018 Co-existence of BRAFV600E and TERT promoter mutations in papillary thyroid carcinoma is associated with tumor aggressiveness, but not with lymph node metastasis. Cancer Manag Res. Epub 2018 May 3. PMID: 29760568.
SUMMARY OF THE STUDY
The subjects of this study were 342 consecutive patients who underwent thyroidectomy for papillary thyroid carcinoma. Of these, 85% underwent total thyroidectomy and the remainder underwent lobectomy. Pre-op neck ultrasound indicated that 251 patients did not have abnormal lymph nodes prior to surgery while 91 patients did have evidence for the spread of the cancer into the lymph nodes of the neck. Central lymph node dissections were performed in all patients and 94% also underwent lateral lymph node dissections. BRAF V600E and the TERT promoter mutations C228T and C250T were analyzed after in all of the surgery specimens.