Is the BRAFV600E mutation useful as a predictor of preoperative risk in papillary thyroid cancer?

ObjectiveRecent studies have shown that a BRAFV600E reflects poor prognosis, mainly in Western countries. However, some clinicians in Japan have suggested that the BRAFV600E mutation is not associated with a poor prognosis. Therefore, we investigated a relationship between BRAFV600E mutation and clinicopathologic factors.MethodsFrom September 2008 to December 2009, we performed routine analysis of the BRAFV600E mutation using thyroid cancer tissue from 424 patients who underwent thyroidectomy with cervical lymph node dissection.ResultsThe BRAFV600E mutation was found in 335 of 424 cases (79%) and was higher in classic papillary thyroid carcinoma (PTC) (79.7%) than in the follicular variant of PTC (62.5%) (P = .019). On univariate analysis, the BRAFV600E mutation was associated with extrathyroidal extension (P = .009) and variants of PTC (P = .019), but a high-risk Metastasis, Patient Age, Completeness of resection, local Invasion and Tumor Size (MACIS) score (≥ 6) (P = .146) and lymph node metastasis (P = .628) were not significantly associated with the BRAFV600E mutation. Multivariate analysis showed that extrathyroidal extension is independently associated with the BRAFV600E mutation (relative ratio: 2.466; 95% confidence interval, 1.213–5.011; P < .013).ConclusionIt is not clear that the BRAFV600E mutation is useful for prediction of poor prognosis of PTC.