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Poorer Prognosis and Higher Prevalence of BRAF V600E Mutation in Synchronous Bilateral Papillary Thyroid Carcinoma

  • Endocrine Tumors
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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The clinical significance of synchronous bilateral papillary thyroid carcinoma (SBiPTC) has not been fully defined, and the prevalence of BRAF V600E mutation in SBiPTC remains unknown. The purpose of this study is to compare the clinical outcomes and BRAF V600E mutation incidence of SBiPTC patients with those of unilateral papillary thyroid carcinoma (UiPTC) patients.

Methods

From 1997 to 2008, a total of 903 patients with papillary thyroid cancer were treated at a single institution. Of 891 studied patients, 177 (19.9%) had SBiPTC and 714 had UiPTC. SBiPTC was defined as cancer diagnosed in both thyroid lobes at the same time or within a period of 3 months. The mean follow-up time was 6 years, ranging from 2.5 to 13.5 years. Rates of disease-free survival (DFS) and overall survival (OS) were calculated and compared. BRAF V600E mutation was determined by polymerase chain reaction (PCR) amplification and DNA sequencing.

Results

Compared with UiPTC patients, patients with SBiPTC were more likely to have larger tumor size, extrathyroidal invasion, lymph node metastasis, and more advanced stage. The 5-year DFS rate was 86.0% for SBiPTC patients and 94.0% for UiPTC patients (p = 0.013). The prevalence of BRAF V600E mutation in the SBiPTC group was significantly higher than that in the UiPTC group (65.7% vs. 50.4%; p = 0.038).

Conclusions

Patients with SBiPTC present with more advanced tumor stage and have shorter disease-free survival than UiPTC patients. Poorer outcomes of these patients may be at least partially explained by the high incidence of BRAF V600E mutation.

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Acknowledgment

This study was supported by National Basic Research Program of China (973 Program, no. 2009CB521704). We thank Peng Lu and Yaqi Jiang for patients’ clinical follow-up, and Fei Teng (Division of Engineering Science, University of Toronto, Toronto, Canada) for technical assistance. We are also grateful to Dr. Robert Wohlhueter (Centers for Disease Control and Prevention, Atlanta, GA; retired) for his contributions to the preparation of the manuscript.

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Authors and Affiliations

  1. Cancer Center, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China

    Weibin Wang MD, PhD, Wenhe Zhao MD, Haiyong Wang MD, PhD, Haohao Wang MD, PhD, Xiangheng Chen MD, Zhongqi Li MD, Xiongfei Yu MD & Lisong Teng MD, PhD

  2. Department of Pathology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China

    Xiaodong Teng MD

  3. Department of Surgery, New York Presbyterian Hospital, and Weill Medical College of Cornell University, New York, USA

    Thomas J. Fahey III MD

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  1. Weibin Wang MD, PhD
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  2. Wenhe Zhao MD
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  3. Haiyong Wang MD, PhD
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  4. Xiaodong Teng MD
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  5. Haohao Wang MD, PhD
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  6. Xiangheng Chen MD
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  7. Zhongqi Li MD
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  9. Thomas J. Fahey III MD
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  10. Lisong Teng MD, PhD
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Correspondence to Lisong Teng MD, PhD.

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Wang, W., Zhao, W., Wang, H. et al. Poorer Prognosis and Higher Prevalence of BRAF V600E Mutation in Synchronous Bilateral Papillary Thyroid Carcinoma. Ann Surg Oncol 19, 31–36 (2012). https://doi.org/10.1245/s10434-011-2096-2

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  • DOI: https://doi.org/10.1245/s10434-011-2096-2

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