期刊
JOURNAL OF CLINICAL ONCOLOGY
卷 33, 期 1, 页码 42-U79出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1200/JCO.2014.56.8253
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资金
- National Institutes of Health (NIH) [R01CA134225, RO1CA113507]
- National Center for Advancing Translational Sciences of NIH and NIH Roadmap for Medical Research [UL1 RR 025005]
- National Science Centre Poland [N N403 194340, N N401 612440]
- Griffith Health Institute (Australia)
- ISCIII [BFU2010-16025, RD06/0020/0060-RD12/0036/0030 FIS]
- TIRONET (Spain) [S2011/BMD-2328]
- NIH [RO1-CA50706]
- Byrne Foundation
- Fondazione Cassa di Risparmio di Perugia [IG 9338]
- Associazione Italiana per la Ricerca sul Cancro (Italy)
- Beadle Family Foundation
- Czech Republic [IGA MH CR NT 139014]
- New South Wales Cancer Institute
- Cancer Council of New South Wales (Australia)
- Ministero della Istruzione Universitaria e Ricerca Scientifica [MIUR20074zw8la]
- NIH/National Institute on Aging [5R03AG042334-02]
- Ministero della Istruzione Universitaria e Ricerca Scientifica
- Associazione Italiana per la Ricerca sul Cancro
- Istituto Toscano Tumori
- Ministero della Salute (Italy)
- Korean Foundation for Cancer Research (South Korea) [CB-2011-03-02]
- NATIONAL CANCER INSTITUTE [R01CA134225, P30CA008748, R01CA050706, R01CA113507] Funding Source: NIH RePORTER
- NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES [UL1TR001079] Funding Source: NIH RePORTER
- NATIONAL CENTER FOR RESEARCH RESOURCES [UL1RR025005] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON AGING [R03AG042334] Funding Source: NIH RePORTER
Purpose To investigate the prognostic value of BRAF V600E mutation for the recurrence of papillary thyroid cancer (PTC). Patients and Methods This was a retrospective multicenter study of the relationship between BRAF V600E mutation and recurrence of PTC in 2,099 patients (1,615 women and 484 men), with a median age of 45 years (interquartile range [IQR], 34 to 58 years) and a median follow-up time of 36 months (IQR, 14 to 75 months). Results The overall BRAF V600E mutation prevalence was 48.5% (1,017 of 2,099). PTC recurrence occurred in 20.9% (213 of 1,017) of BRAF V600E mutation-positive and 11.6% (125 of 1,082) of BRAF V600E mutation-negative patients. Recurrence rates were 47.71 (95% CI, 41.72 to 54.57) versus 26.03 (95% CI, 21.85 to 31.02) per 1,000 person-years in BRAF mutation-positive versus -negative patients (P < .001), with a hazard ratio (HR) of 1.82 (95% CI, 1.46 to 2.28), which remained significant in a multivariable model adjusting for patient sex and age at diagnosis, medical center, and various conventional pathologic factors. Significant association between BRAF mutation and PTC recurrence was also found in patients with conventionally low-risk disease stage I or II and micro-PTC and within various subtypes of PTC. For example, in BRAF mutation-positive versus -negative follicular-variant PTC, recurrence occurred in 21.3% (19 of 89) and 7.0% (24 of 342) of patients, respectively, with recurrence rates of 53.84 (95% CI, 34.34 to 84.40) versus 19.47 (95% CI, 13.05 to 29.04) per 1,000 person-years (P < .001) and an HR of 3.20 (95% CI, 1.46 to 7.02) after adjustment for clinicopathologic factors. BRAF mutation was associated with poorer recurrence-free probability in Kaplan-Meier survival analyses in various clinicopathologic categories. Conclusion This large multicenter study demonstrates an independent prognostic value of BRAF V600E mutation for PTC recurrence in various clinicopathologic categories. (C) 2014 by American Society of Clinical Oncology
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