2015 HSC Section 1 Book of Articles

TABLE I. Patient Characteristics.

Lateral Neck Disease

Central Neck Disease

Patient No.

Age, yr

Tumor Size, cm

Pulmonary Metastases Recurrence

Lymphovascular Invasion

Extracapsular Extension

MACIS Score

BRAF Mutation

Histology

1 2 3 4 5 6 7 8 9

15.2 1.9 11.2 6 10.9 NR 13.4 3 13.7 0.3 2.8 2.6 12.4 1.3 11.8 3.3 16.2 0.3 13.8 2.7 18.3 NR 12.5 3.9 12.8 1.4 15.1 0.8 13 1.6 16.7 2.3 15.5 4.2 14.8 0.5 17.4 0.9

N Y Y Y Y N N N N Y Y Y N N N N N Y N

N Y Y Y Y Y N N N Y Y Y N N Y Y Y Y Y

N Y N Y N Y N N N N N Y N N N Y N N N

NR NR

PTC PTC

NR

N Y Y

3.67 Positive 8.9 Negative — Negative 8 Negative 4.19 Negative 7.88 Negative 3.49 Positive 4.09 Negative 3.19 Negative 4.91 Positive — Positive 8.27 Negative 3.52 Negative 3.34 Positive 4.58 Positive 4.79 Negative 5.36 Positive 4.25 Negative 4.37 Negative

Y Y

Y

FVPTC FVPTC FVPTC FVPTC

NR

NR

NR

N N N N

Y Y N

Y

NR

PTC

Y

FVPTC

NR

NR

NR

PTC PTC PTC

N Y

N Y

10 11 12 13 14 15 16 17 18 19

Y N

NR

NR

NR

FVPTC FVPTC

Y N N Y Y

Y N N

N N N N N N N

PTC PTC

NR

PTC, oncocytic variant

Y

PTC

Y Y

Y N

PTC–TCM

PTC

NR

NR

FVPTC 5 follicular variant of papillary thyroid carcinoma; MACIS 5 metastases, age at diagnosis, completeness of resection, invasion, size of the tumor scoring; N 5 no; NR 5 not reported; PTC 5 papillary thyroid carcinoma; TCM 5 tall cell morphology; Y 5 yes.

literature, the cumulative presence of BRAF V600E in pediatric thyroid cancer was 28.4% (Table III).

with a higher MACIS score in BRAF wild-type patients. The presence of tumor size > 1 cm was not statistically associated with the BRAF V600E mutation ( P 5 .851). Our literature review identified a total of five stud- ies that examined pediatric patients with well- differentiated thyroid cancer and assessed for the BRAF gene mutation. Prevalence was variable ranging from 0% to 36%. Two studies reviewed the disease character- istics of the patients and did not find an association between BRAF V600E and aggressive disease. When the results of our study were added to the existing

DISCUSSION The BRAF V600E gene mutation has been increas- ingly studied in various disease entities such as thyroid carcinoma, melanoma, astrocytoma, and colon cancers. Chemotherapeutic agents have been successfully used to target this gene mutation in clinical trials in adults. Numerous studies have attempted to correlate the

TABLE II. Association of BRAF V600E With Disease Factors.

Independent Variable

Wild-Type BRAF

Mutant BRAF

Significance

P 5 .013 P 5 .633 P 5 .617 P 5 .106 P 5 .580 P 5 1.00 P 5 .851

Percentage with PTC histology

33.3% (4/12) 50% (6/12) 75% (9/12) 42% (5/12) 77.8% (7/9) 62.5% (5/8) 36.3% (4/11)

100% (7/7) 28.5% (2/7) 57.1% (4/7) 0% (0/7) 60% (3/5) 60% (3/5) 16.7% (1/6)

Percentage with lateral neck metastases Percentage with central neck metastases Percentage with pulmonary metastases Percentage with lymphovascular invasion Percentage with extrathyroidal extension

Percentage with microcarcinoma

t 52 1.221, P 5 .239

Average age, yr*

12.9 5.59 2.23

14.8 4.23 2.08

P 5 .087

Average MACIS score* Average tumor size, cm*

t 5 0.176, P 5 .863

*These continuous variables describe differences between the two groups BRAF V600E and BRAF wild-type. MACIS 5 metastases, age at diagnosis, completeness of resection, invasion, size of the tumor; PTC 5 papillary thyroid carcinoma.

Givens et al.: BRAF V600E and Pediatric Thyroid Carcinoma

Laryngoscope 124: September 2014

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