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TERT Promoter Mutation and Extent of Thyroidectomy in Patients with 1–4 cm Intrathyroidal Papillary Carcinoma

There are concerns regarding overtreatment in papillary thyroid carcinoma (PTC). BRAF V600E and TERT promoter mutations play important roles in the development of PTC. However, initial surgical approaches for PTC based on genetic characteristics remain unclear. The present study aimed to identify ge...

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Autores principales: Ebina, Aya, Togashi, Yuki, Baba, Satoko, Sato, Yukiko, Sakata, Seiji, Ishikawa, Masashi, Mitani, Hiroki, Takeuchi, Kengo, Sugitani, Iwao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464551/
https://www.ncbi.nlm.nih.gov/pubmed/32751594
http://dx.doi.org/10.3390/cancers12082115
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author Ebina, Aya
Togashi, Yuki
Baba, Satoko
Sato, Yukiko
Sakata, Seiji
Ishikawa, Masashi
Mitani, Hiroki
Takeuchi, Kengo
Sugitani, Iwao
author_facet Ebina, Aya
Togashi, Yuki
Baba, Satoko
Sato, Yukiko
Sakata, Seiji
Ishikawa, Masashi
Mitani, Hiroki
Takeuchi, Kengo
Sugitani, Iwao
author_sort Ebina, Aya
collection PubMed
description There are concerns regarding overtreatment in papillary thyroid carcinoma (PTC). BRAF V600E and TERT promoter mutations play important roles in the development of PTC. However, initial surgical approaches for PTC based on genetic characteristics remain unclear. The present study aimed to identify genetic mutations as predictors of prognosis and to establish proper indications for lobectomy (LT) in patients with 1–4 cm intrathyroidal PTC. Prospectively accumulated data from 685 consecutive patients with PTC who underwent primary thyroid surgery at the Cancer Institute Hospital, Tokyo, Japan, between 2001 and 2012 were retrospectively reviewed. Of the 685 patients examined, 538 (78.5%) had BRAF V600E mutation and 133 (19.4%) had TERT promoter mutations. Patients with TERT promoter mutations displayed significantly worse outcomes than those without mutations (10-year cause-specific survival (CSS): 73.7% vs. 98.1%, p < 0.001; 10-year disease-free survival (DFS): 53.7% vs. 93.3%, p < 0.001). As for extent of thyroidectomy among TERT mutation-negative patients with 1–4 cm intrathyroidal PTC, patients who underwent LT showed no significant differences in 10-year CSS and 10-year DFS compared to patients who had total thyroidectomy (TT) under propensity score-matching. Avoiding TT for those patients indicates a possible pathway to prevent overtreatment and reduce postoperative complications.
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spelling pubmed-74645512020-09-04 TERT Promoter Mutation and Extent of Thyroidectomy in Patients with 1–4 cm Intrathyroidal Papillary Carcinoma Ebina, Aya Togashi, Yuki Baba, Satoko Sato, Yukiko Sakata, Seiji Ishikawa, Masashi Mitani, Hiroki Takeuchi, Kengo Sugitani, Iwao Cancers (Basel) Article There are concerns regarding overtreatment in papillary thyroid carcinoma (PTC). BRAF V600E and TERT promoter mutations play important roles in the development of PTC. However, initial surgical approaches for PTC based on genetic characteristics remain unclear. The present study aimed to identify genetic mutations as predictors of prognosis and to establish proper indications for lobectomy (LT) in patients with 1–4 cm intrathyroidal PTC. Prospectively accumulated data from 685 consecutive patients with PTC who underwent primary thyroid surgery at the Cancer Institute Hospital, Tokyo, Japan, between 2001 and 2012 were retrospectively reviewed. Of the 685 patients examined, 538 (78.5%) had BRAF V600E mutation and 133 (19.4%) had TERT promoter mutations. Patients with TERT promoter mutations displayed significantly worse outcomes than those without mutations (10-year cause-specific survival (CSS): 73.7% vs. 98.1%, p < 0.001; 10-year disease-free survival (DFS): 53.7% vs. 93.3%, p < 0.001). As for extent of thyroidectomy among TERT mutation-negative patients with 1–4 cm intrathyroidal PTC, patients who underwent LT showed no significant differences in 10-year CSS and 10-year DFS compared to patients who had total thyroidectomy (TT) under propensity score-matching. Avoiding TT for those patients indicates a possible pathway to prevent overtreatment and reduce postoperative complications. MDPI 2020-07-30 /pmc/articles/PMC7464551/ /pubmed/32751594 http://dx.doi.org/10.3390/cancers12082115 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ebina, Aya
Togashi, Yuki
Baba, Satoko
Sato, Yukiko
Sakata, Seiji
Ishikawa, Masashi
Mitani, Hiroki
Takeuchi, Kengo
Sugitani, Iwao
TERT Promoter Mutation and Extent of Thyroidectomy in Patients with 1–4 cm Intrathyroidal Papillary Carcinoma
title TERT Promoter Mutation and Extent of Thyroidectomy in Patients with 1–4 cm Intrathyroidal Papillary Carcinoma
title_full TERT Promoter Mutation and Extent of Thyroidectomy in Patients with 1–4 cm Intrathyroidal Papillary Carcinoma
title_fullStr TERT Promoter Mutation and Extent of Thyroidectomy in Patients with 1–4 cm Intrathyroidal Papillary Carcinoma
title_full_unstemmed TERT Promoter Mutation and Extent of Thyroidectomy in Patients with 1–4 cm Intrathyroidal Papillary Carcinoma
title_short TERT Promoter Mutation and Extent of Thyroidectomy in Patients with 1–4 cm Intrathyroidal Papillary Carcinoma
title_sort tert promoter mutation and extent of thyroidectomy in patients with 1–4 cm intrathyroidal papillary carcinoma
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464551/
https://www.ncbi.nlm.nih.gov/pubmed/32751594
http://dx.doi.org/10.3390/cancers12082115
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