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Título: | BRAF V600E confers male sex disease-specific mortality risk in patients with papillary thyroid cancer |
Autor: | Wang, Fei; Zhao, Shihua; Shen, Xiaopei; Zhu, Guangwu; Liu, Rengyun; Viola, David; Elisei, Rossella; Puxeddu, Efisio; Fugazzola, Laura; Colombo, Carla; Jarzab, Barbara; Czarniecka, Agnieszka; Lam, Alfred K.; Mian, Caterina; Vianello, Federica; Yip, Linwah; Riesco-Eizaguirre, Garcilaso CSIC ORCID; Santisteban, Pilar CSIC ORCID; O’Neill, Christine J.; Sywak, Mark S.; Clifton-Bligh, Roderick; Bendlova, Bela; Sýkorová, Vlasta; Wang, Yangang; Xing, Mingzhao | Fecha de publicación: | 2018 | Editor: | American Society of Clinical Oncology | Citación: | Journal of Clinical Oncology 36(27): 2787-2795 (2018) | Resumen: | [Purpose]: To test whether the prognostic risk of male sex in papillary thyroid cancer (PTC) is determined by BRAF V600E and can thus be stratified by BRAF status. [Patients and Methods]: We retrospectively investigated the relationship between male sex and clinicopathologic outcomes in PTC, particularly mortality, with respect to BRAF status in 2,638 patients (male, n = 623; female, n = 2,015) from 11 centers in six countries, with median age of 46 years (interquartile range, 35-58 years) at diagnosis and median follow-up time of 58 months (interquartile range, 26-107 months). [Results]: Distant metastasis rates in men and women were not different in wild-type BRAF PTC but were different in BRAF V600E PTC: 8.9% (24 of 270) and 3.7% (30 of 817; P = .001), respectively. In wild-type BRAF PTC, mortality rates were 1.4% (five of 349) versus 0.9% (11 of 1175) in men versus women (P = .384), with a hazard ratio (HR) of 1.59 (95% CI, 0.55 to 4.57), which remained insignificant at 0.70 (95% CI, 0.23 to 2.09) after clinicopathologic multivariable adjustment. In BRAF V600E PTC, mortality rates were 6.6% (18 of 272) versus 2.9% (24 of 822) in men versus women (P = .006), with an HR of 2.43 (95% CI, 1.30 to 4.53), which remained significant at 2.74 (95% CI, 1.38 to 5.43) after multivariable adjustment. In conventional-variant PTC, male sex similarly had no effect in wild-type BRAF patients; mortality rates in BRAF V600E patients were 7.2% (16 of 221) versus 2.9% (19 of 662) in men versus women (P = .004), with an HR of 2.86 (95% CI, 1.45 to 5.67), which remained significant at 3.51 (95% CI, 1.62 to 7.63) after multivariable adjustment. [Conclusion]: Male sex is a robust independent risk factor for PTC-specific mortality in BRAF V600E patients but not in wild-type BRAF patients. The prognostic risk of male sex in PTC can thus be stratified by BRAF status in clinical application. | URI: | http://hdl.handle.net/10261/188047 | DOI: | 10.1200/JCO.2018.78.5097 | Identificadores: | doi: 10.1200/JCO.2018.78.5097 e-issn: 1527-7755 issn: 0732-183X |
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