BRAF(V600E) Positivity-Dependent Effect of Age on Papillary Thyroid Cancer Recurrence Risk

SIMPLE SUMMARY: This study investigated the impact of age and BRAF(V600E) mutation on papillary thyroid cancer (PTC) recurrence. Among patients with BRAF(V600E)-positive PTC, those under 35 years of age had a significantly higher risk of recurrence than those over 55 years. However, in BRAF(V600E)-negative patients, age had no impact on the risk of recurrence. These findings emphasize the importance of considering age and mutation status in tailoring PTC treatment and follow-up. ABSTRACT: BRAF(V600E) positivity is associated with increased aggressiveness of papillary thyroid cancer (PTC), and age is an important prognostic factor. However, the association between age and BRAF(V600E) positivity and the recurrence risk has not been investigated. This study aimed to investigate the impact of age on recurrence between patients with BRAF(V600E)-positive and -negative PTC. Patients with PTC who underwent initial thyroid surgery between January 2010 and December 2018 at Seoul St. Mary’s Hospital (Seoul, Republic of Korea) were retrospectively reviewed. The BRAF(V600E)-positive (n = 1768) and BRAF(V600E)-negative groups (n = 428) were divided into two subgroups: younger (<35 years) and older groups (≥55 years). In the BRAF(V600E)-positive group, the younger group exhibited higher lymphatic and vascular invasion rates, more positive lymph nodes, higher lymph node ratios, and higher recurrence rates than the older group (5.9% vs. 2.1%). Multivariate analysis revealed that age, lymphatic invasion, and N category were significant risk factors in the BRAF(V600E)-positive group. In the BRAF(V600E)-positive group, the younger group had a higher recurrence risk than the older group (OR, 2.528; 95% confidence interval, 1.443–4.430; p = 0.001). In the BRAF(V600E)-negative group, age had no impact on recurrence risk. These results contribute to tailored treatment strategies and informed patient management.