<i>BRAF</i>: A Tool in the Decision to Perform Elective Neck Dissection?

Dutenhefner, Simone Elisa; Marui, Suemi; Santos, André Bandiera de Oliveira; Lima, Erika Urbano de; Inoue, Milton; Neto, José Sampaio; Shiang, Christina; Fukushima, Júlia Tizue; Cernea, Cláudio Roberto; Friguglietti, Celso U. M.

doi:10.1089/thy.2012.0304

Cited by 27 publications

(25 citation statements)

References 37 publications

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“…The most prevalent subgroup of classical and follicular variants of PTC showed no association of BRAF mutation with poor prognostic factors or poor outcome. Our findings corroborated recent studies (20,21,22,23) and also discarded the association of p.V600E with higher frequency of cervical LN and distant metastases (13,24,25,26). In order to justify the lack of association, it has also been proposed that it is not the intratumoral presence of BRAF mutation that determines prognosis but the higher frequency of mutant BRAF alleles, identified in an innovatory analysis of pyrosequencing technique, that favors more frequent recurrence (27).…”

Section: Clinical Study D L S Danilovic and Others Preoperative Molecsupporting

confidence: 91%

“…Patients with pre-operative evidence of LNs metastasis underwent therapeutic neck dissection. A subgroup of patients without clinical or ultra sonographic evidence of cervical LN metastasis was submitted to prophylactic central neck dissection (CND), as a part of another institutional protocol (13). Dutenhefner et al (13) selected prospectively 45 patients without known LN metastasis from a group of 52 consecutive patients with cytological diagnosis of Bethesda V and VI to be submitted to TT and CND.…”

Section: Patientsmentioning

confidence: 99%

“…Briefly, slides were placed in the bath with histological xylene for 24 h to remove the coverslip and the material was then scraped from the slide and transferred to a clean microtube for extraction using phenol/chloroform/isoamyl alcohol. DNA extraction from material conserved in paraffin was performed as previously described (13). One milliliter of xylene preheated in an incubator at 95 8C was added in a microtube of 1.5 ml with three sections equivalent to 10 mm of conserved tumor.…”

Section: Braf and Ras Mutationsmentioning

confidence: 99%

“…A recent study that investigated the prognostic significance of microscopic LNs metastasis detected with prophylactic neck dissection has proved they had no impact in the low loco regional recurrence rates (29). Dutenhefner et al (13) studied PTC submitted to prophylactic CND and found no difference in the LNs metastasis presence between BRAF C and BRAF K . Our prospective study confirmed the high frequency of microscopic LNs metastasis diagnosed in prophylactic CND, despite the presence of BRAF mutation.…”

Section: Clinical Study D L S Danilovic and Others Preoperative Molecmentioning

confidence: 99%

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Pre-operative role of BRAF in the guidance of the surgical approach and prognosis of differentiated thyroid carcinoma

Danilovic

Lima

Domingues

et al. 2014

European Journal of Endocrinology

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Objective: The p.V600E BRAF and RAS mutations are found in 30-80% of differentiated thyroid carcinoma (DTC). BRAF mutation has been associated with poor prognosis. This study investigated the role of molecular studies in preoperative diagnosis of DTC and the association of p.V600E mutation with prognostic factors. Design: Prospective study. Methods: A total of 202 patients with cytological diagnosis of Bethesda III-VI underwent preoperative molecular studies and subsequent thyroidectomy. p.V600E and RAS mutations were studied in the cytology smears, using real-time PCR genotyping technique. The BRAF mutation (BRAF C or BRAF K ) was correlated with histological and clinical findings. Results: Molecular study of 172 nodules with Bethesda III-V cytology improved negative predictive value and accuracy of Bethesda III and IV diagnosis. BRAF mutation was present in 65% of 94 DTC and p.Q61R NRAS in one. Except for age, BRAF C and BRAF K did not differ in sex, tumor size, histological subtype, multifocality, vascular invasion, extrathyroidal extension, or prognostic staging. Among papillary carcinomas, lymph node (LN) metastasis was diagnosed in 23% BRAF C and 37% BRAF K . Distant metastasis occurred in four BRAF K . Recurrent or persistent disease was more frequent in BRAF K (26.7 vs 3.3% BRAF C , PZ0.002) along follow-up of 29.8G10 months. BRAF C patients without LN metastasis by pre-operative evaluation submitted to thyroidectomy with central neck dissection (CND) had more frequent LN metastasis (45 vs 5% no CND, PZ0.002), but no difference in clinical outcome was observed. Conclusions: Pre-operative identification of BRAF mutation improved cytological diagnosis of DTC, but it was not associated with poor prognostic factors. Prophylactic CND did not guarantee better outcome in BRAF C patients.

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Section: Clinical Study D L S Danilovic and Others Preoperative Molecsupporting

confidence: 91%

Section: Patientsmentioning

confidence: 99%

Section: Braf and Ras Mutationsmentioning

confidence: 99%

Section: Clinical Study D L S Danilovic and Others Preoperative Molecmentioning

confidence: 99%

See 2 more Smart Citations

Pre-operative role of BRAF in the guidance of the surgical approach and prognosis of differentiated thyroid carcinoma

Danilovic

Lima

Domingues

et al. 2014

European Journal of Endocrinology

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“…Although the BRAF gene mutation is associated with greater initial aggressiveness of papillary carcinoma, including higher frequency of lymph node metastases, the available data are not sufficient to rule out or indicate elective dissection of the central compartment lymph nodes on the grounds of the absence or presence of this mutation, respectively (84,85).…”

Section: Recommendation 32mentioning

confidence: 96%

Thyroid nodules and differentiated thyroid cancer: update on the Brazilian consensus

Rosário

Ward

Carvalho

et al. 2013

Arq Bras Endocrinol Metab

122

147

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Thyroid nodules are frequent findings, especially when sensitive imaging methods are used. Although thyroid cancer is relatively rare, its incidence is increasing, particularly in terms of small tumors, which have an uncertain clinical relevance. Most patients with differentiated thyroid cancer exhibit satisfactory clinical outcomes when treatment is appropriate, and their mortality rate is similar to that of the overall population. However, relapse occurs in a considerable fraction of these patients, and some patients stop responding to conventional treatment and eventually die from their disease. Therefore, the challenge is how to identify the individuals who require more aggressive disease management while sparing the majority of patients from unnecessary treatments and procedures. We have updated the Brazilian Consensus that was published in 2007, emphasizing the diagnostic and therapeutic advances that the participants, representing several Brazilian university centers, consider most relevant in clinical practice. The formulation of the present guidelines was based on the participants' experience and a review of the relevant literature. Arq Bras Endocrinol Metab. 2013;57(4):240-64 Keywords Thyroid nodules; thyroid cancer; Brazilian consensus; update RESUMO Nódulos tireoidianos são muito frequentes, sobretudo quando se empregam métodos sensí-veis de imagem. Embora o câncer seja proporcionalmente raro, sua incidência vem aumentando, especialmente de tumores pequenos, cuja evolução clínica é incerta. A maioria dos pacientes com carcinoma diferenciado de tireoide evolui bem quando adequadamente tratada, com índices de mortalidade similares à população geral. Por outro lado, um percentual não desprezível apresenta recidivas e alguns eventualmente não respondem às terapias convencionais, evoluindo para óbito. Assim, o desafio é distinguir os pacientes merecedores de condutas mais agressivas e, ao mesmo tempo e não menos importante, poupar a maioria de tratamentos e procedimentos desnecessários. Atualizamos o Consenso Brasileiro publicado em 2007, ressaltando os avanços diagnósticos e terapêuticos que os participantes, de diferentes Centros Universitários do Brasil, consideram mais relevantes para prática clínica. A elaboração dessas diretrizes foi baseada na experiência dos participantes e revisão da literatura pertinente. Arq Bras Endocrinol Metab. 2013;57(4):240-64 Descritores

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Noncoding RNAs in Papillary Thyroid Cancer: Interaction with Cancer-Associated Fibroblasts (CAFs) in the Tumor Microenvironment (TME) and Regulators of Differentiation and Lymph Node Metastasis

Dadafarin

Carnazza

Islam

et al. 2021

Advances in Experimental Medicine and Biology

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BRAF: A Tool in the Decision to Perform Elective Neck Dissection?

Abstract: Testing for the BRAF mutation does not help in deciding whether or not to perform CND.

Cited by 27 publications

References 37 publications

Pre-operative role of BRAF in the guidance of the surgical approach and prognosis of differentiated thyroid carcinoma

Pre-operative role of BRAF in the guidance of the surgical approach and prognosis of differentiated thyroid carcinoma

Thyroid nodules and differentiated thyroid cancer: update on the Brazilian consensus

Noncoding RNAs in Papillary Thyroid Cancer: Interaction with Cancer-Associated Fibroblasts (CAFs) in the Tumor Microenvironment (TME) and Regulators of Differentiation and Lymph Node Metastasis

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