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Endocrine Abstracts (2014) 35 P1117 | DOI: 10.1530/endoabs.35.P1117

Hospital Virgen de la Salud, Toledo, Spain.

Introduction and objective: Prophylactic central lymph node dissection (CLND) in patients with suspected papillary thyroid cancer (PTC) without evident lymph node metastasis (LNM), remains debatable. We propose to evaluate whether BRAF V600E mutation presence, could help to identify patients at risk for LMN.

Methods: Retrospective study of patients with diagnosis of PTC, who underwent total thyroidectomy during 2002 and 2013 (n: 256) in our hospital. Patients with pathological diagnosis of PTC, whose BRAF V600E mutation status was known (n: 170) and who underwent lymphadenectomy (n: 118) as well, were selected. LMN presence was correlated with BRAF V600E mutation status (presence of BRAF V600E mutation vs WT) and with other clinicopathological factors (age, initial tumor size, gender, etc.). A multivariate analysis was performed to assess independent factors related to LNM. DNA was extracted from paraffin-embebbed tissues section and V600E mutations were detected by HRM followed by sequencing confirmation.

Results: From 118 PTC studied, 74.6% were women with an age at diagnosis of 44.8±15.4 years. The prevalence of the V600E mutation was 62.7%. 60.2% of patients had LNM, in which 57.7% were BRAF V600E mutation carriers and 43.3% were WT (P=0.170, NS). We did not find association with other clinicopathological factors, except with extrathyroidal affectation and male gender, which were associated with higher prevalence of LNM (P<0.05). In the multivariate analysis, the only independent factor associated with LMN was extrathyroidal affectation (OR: 3.0 95% CI: 1.8–7.9, P<0,05).

Conclusions: Our results do not support using the presence of V600E mutation to decide whether to perform or not prophylactic CLND in patients with PTC. More prospective studies will be necessary.

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