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  • BRAF V600E Confers Male Sex Disease-Specific Mortality Risk in Patients With Papillary Thyroid Cancer

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    Author(s)
    Wang, Fei
    Zhao, Shihua
    Shen, Xiaopei
    Zhu, Guangwu
    Liu, Rengyun
    Viola, David
    Elisei, Rossella
    Puxeddu, Efisio
    Fugazzola, Laura
    Colombo, Carla
    Jarzab, Barbara
    Czarniecka, Agnieszka
    Lam, Alfred K
    Mian, Caterina
    Vianello, Federica
    Yip, Linwah
    Riesco-Eizaguirre, Garcilaso
    Santisteban, Pilar
    O'Neill, Christine J
    Sywak, Mark S
    Clifton-Bligh, Roderick
    Bendlova, Bela
    Sykorova, Vlasta
    Wang, Yangang
    Xing, Mingzhao
    Griffith University Author(s)
    Lam, Alfred K.
    Year published
    2018
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    Abstract
    Purpose: To test whether the prognostic risk of male sex in papillary thyroid cancer (PTC) is determined by BRAF V600E and can thus be stratified by BRAF status. Patients and Methods: We retrospectively investigated the relationship between male sex and clinicopathologic outcomes in PTC, particularly mortality, with respect to BRAF status in 2,638 patients (male, n = 623; female, n = 2,015) from 11 centers in six countries, with median age of 46 years (interquartile range, 35-58 years) at diagnosis and median follow-up time of 58 months (interquartile range, 26-107 months). Results: Distant metastasis rates in men and women ...
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    Purpose: To test whether the prognostic risk of male sex in papillary thyroid cancer (PTC) is determined by BRAF V600E and can thus be stratified by BRAF status. Patients and Methods: We retrospectively investigated the relationship between male sex and clinicopathologic outcomes in PTC, particularly mortality, with respect to BRAF status in 2,638 patients (male, n = 623; female, n = 2,015) from 11 centers in six countries, with median age of 46 years (interquartile range, 35-58 years) at diagnosis and median follow-up time of 58 months (interquartile range, 26-107 months). Results: Distant metastasis rates in men and women were not different in wild-type BRAF PTC but were different in BRAF V600E PTC: 8.9% (24 of 270) and 3.7% (30 of 817; P = .001), respectively. In wild-type BRAF PTC, mortality rates were 1.4% (five of 349) versus 0.9% (11 of 1175) in men versus women (P = .384), with a hazard ratio (HR) of 1.59 (95% CI, 0.55 to 4.57), which remained in-significant at 0.70 (95% CI, 0.23 to 2.09) after clinicopathologic multivariable adjustment. In BRAF V600E PTC, mortality rates were 6.6% (18 of 272) versus 2.9% (24 of 822) in men versus women (P = .006), with an HR of 2.43 (95% CI, 1.30 to 4.53), which remained significant at 2.74 (95% CI, 1.38 to 5.43) after multivariable adjustment. In conventional-variant PTC, male sex similarly had no effect in wild-type BRAF patients; mortality rates in BRAF V600E patients were 7.2% (16 of 221) versus 2.9% (19 of 662) in men versus women (P = .004), with an HR of 2.86 (95% CI, 1.45 to 5.67), which remained significant at 3.51 (95% CI, 1.62 to 7.63) after multivariable adjustment. Conclusion: Male sex is a robust independent risk factor for PTC-specific mortality in BRAF V600E patients but not in wild-type BRAF patients. The prognostic risk of male sex in PTC can thus be stratified by BRAF status in clinical application.
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    Journal Title
    JOURNAL OF CLINICAL ONCOLOGY
    Volume
    36
    Issue
    27
    DOI
    https://doi.org/10.1200/JCO.2018.78.5097
    Copyright Statement
    © 2018 American Society of Clinical Oncology. The attached file is reproduced here in accordance with the copyright policy of the publisher. Please refer to the journal's website for access to the definitive, published version.
    Subject
    Clinical sciences
    Oncology and carcinogenesis
    Publication URI
    http://hdl.handle.net/10072/383029
    Collection
    • Journal articles

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