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dc.contributor.authorTao, Yubing
dc.contributor.authorWang, Fei
dc.contributor.authorShen, Xiaopei
dc.contributor.authorZhu, Guangwu
dc.contributor.authorLiu, Rengyun
dc.contributor.authorViola, David
dc.contributor.authorElisei, Rossella
dc.contributor.authorPuxeddu, Efisio
dc.contributor.authorFugazzola, Laura
dc.contributor.authorColombo, Carla
dc.contributor.authorJarzab, Barbara
dc.contributor.authorCzarniecka, Agnieszka
dc.contributor.authorLam, Alfred K
dc.contributor.authorMian, Caterina
dc.contributor.authoret al.
dc.date.accessioned2021-08-02T01:49:29Z
dc.date.available2021-08-02T01:49:29Z
dc.date.issued2021
dc.identifier.issn0021-972X
dc.identifier.doi10.1210/clinem/dgab286
dc.identifier.urihttp://hdl.handle.net/10072/406478
dc.description.abstractCONTEXT: How lymph node metastasis (LNM)-associated mortality risk is affected by BRAF V600E in papillary thyroid cancer (PTC) remains undefined. OBJECTIVE: To study whether BRAF V600E affected LNM-associated mortality in PTC. DESIGN, SETTING, PARTICIPANTS: We retrospectively analyzed the effect of LNM on PTC-specific mortality with respect to BRAF status in 2638 patients (2015 females and 623 males) from 11 centers in 6 countries, with median age of 46 (IQR 35-58) years and median follow-up time of 58 (IQR 26-107) months. RESULTS: Overall, LNM showed a modest mortality risk in wild-type BRAF patients but a strong one in BRAFV600E patients. In conventional PTC (CPTC), LNM showed no increased mortality risk in wild-type BRAF patients but a robustly increased one in BRAFV600E patients; mortality rates were 2/659 (0.3%) versus 4/321 (1.2%) in non-LNM versus LNM patients (P=0.094) with wild-type BRAF, corresponding to a hazard ratio (HR) (95% CI) of 4.37 (0.80-23.89), which remained insignificant at 3.32 (0.52-21.14) after multivariate adjustment. In BRAFV600E CPTC, morality rates were 7/515 (1.4%) versus 28/363 (7.7%) in non-LNM versus LNM patients (P<0.001), corresponding to HR of 4.90 (2.12-11.29) or, after multivariate adjustment, 5.76 (2.19-15.11). Adjusted mortality HR of coexisting LNM and BRAFV600E versus absence of both was 27.39 (5.15-145.80), with Kaplan-Meier analyses showing a similar synergism. CONCLUSIONS: LNM-associated mortality risk is sharply differentiated by the BRAF status in PTC; in CPTC, LNM showed no increased mortality risk with wild-type BRAF but a robust one with BRAF mutation. These results have strong clinical relevance.
dc.description.peerreviewedYes
dc.languageeng
dc.publisherThe Endocrine Society
dc.relation.ispartofjournalThe Journal of Clinical Endocrinology & Metabolism
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchcode3202
dc.subject.keywordsBRAF mutation
dc.subject.keywordslymph node metastasis
dc.subject.keywordsmortality
dc.subject.keywordsprognostic molecular marker
dc.subject.keywordsrisk stratification
dc.titleBRAF V600E Status Sharply Differentiates Lymph Node Metastasis-associated Mortality Risk in Papillary Thyroid Cancer
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationTao, Y; Wang, F; Shen, X; Zhu, G; Liu, R; Viola, D; Elisei, R; Puxeddu, E; Fugazzola, L; Colombo, C; Jarzab, B; Czarniecka, A; Lam, AK; et al., BRAF V600E Status Sharply Differentiates Lymph Node Metastasis-associated Mortality Risk in Papillary Thyroid Cancer, The Journal of Clinical Endocrinology & Metabolism, 2021
dc.date.updated2021-07-27T22:24:27Z
dc.description.versionAccepted Manuscript (AM)
gro.description.notepublicThis publication has been entered as an advanced online version in Griffith Research Online.
gro.rights.copyright© 2021 Oxford University Press. This is a pre-copy-editing, author-produced PDF of an article accepted for publication in the Journal of Clinical Endocrinology and Metabolism following peer review. The definitive publisher-authenticated version BRAF V600E Status Sharply Differentiates Lymph Node Metastasis-associated Mortality Risk in Papillary Thyroid Cancer, Journal of Clinical Endocrinology and Metabolism, 2021 is available online at: https://doi.org/10.1210/clinem/dgab286.
gro.hasfulltextFull Text
gro.griffith.authorLam, Alfred K.


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