BRAFV600E Mutation is Associated with Decreased Disease-Free Survival in Papillary Thyroid Cancer

Abstract Background: The prevalence of thyroid cancer is rising worldwide. Although thyroid cancer has a favorable prognosis, up to 20% of patients experienced recurrent disease at some point during follow-up. The present study aimed to examine the recurrent factors that determined the outcomes of papillary thyroid cancer (PTC) and the characteristic trends in Thai patients over the last 30 years in a single institute. Methods: We reviewed the clinical data of all patients with PTC who were treated between 1987 and 2019. Clinical characteristics, epidemic trends, factors associated with the persistent or recurrent disease, disease-specific survival rate and disease-free survival rate were analysed. Results: A total of 235 patients with PTC who were registered between 1987 and 2019 were reviewed. The mean age was 41.0 ± 14.3 years, with a mean follow-up of 113 months. Papillary thyroid microcarcinoma (PTMC) was consistently increased and accounted for 21.4% (50/235) of total cases. According to American Thyroid Association (ATA) risk stratification, high ATA risk was found 24% of all PTMCs in the last decade, and 16.7% of these patients experienced local recurrence during the follow-up period. Coexistence with Hashimoto’s thyroiditis (HT) was found in one-fifth of the patients with PTC and was correlated with a low recurrent rate (HR 0.21, p = 0.009). Factors associated with the persistent or recurrent of disease included age > 55 years and high ATA risk. The overall disease-free survival rate and disease-specific survival rate were 77.4% and 98.3%, respectively. Conclusions: The prognosis of PTC is generally considered favorable. However, more than one-third of patients with PTMC demonstrated more aggressive clinical behavior, particularly in the last decade of the study. Coexistence with HT might contribute to a better prognosis in cases of PTC.

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The Age Threshold of the 8th Edition AJCC Classification Is Useful for Indicating Patients with Aggressive Papillary Thyroid Cancer in Clinical Practice .

10.21203/rs.3.rs-35309/v1 ◽

2020 ◽

Author(s):

Krzysztof Kaliszewski ◽

Dorota Diakowska ◽

Łukasz Nowak ◽

Beata Wojtczak ◽

Jerzy Rudnicki

Keyword(s):

Overall Survival ◽

Thyroid Cancer ◽

Clinical Practice ◽

Tumor Progression ◽

Papillary Thyroid Cancer ◽

Distant Metastasis ◽

Disease Free Survival ◽

Papillary Thyroid ◽

Free Survival ◽

Younger Patients

Abstract Background: Papillary thyroid cancer (PTC) is unique among cancers in that patient age is a consideration in staging. One of the most important modifications in the 8th Edition of the American Joint Committee on Cancer (AJCC) classification, which was introduced in 2018, was to increase the age cutoff for risk stratification in PTC from 45 to 55 years. However, whether this cutoff is useful in clinical practice remains controversial. In the present study, we assessed how well this new age threshold stratifies patients with aggressive PTC.Methods: We retrospectively analyzed the clinicopathological features and overall survival rate of 523 patients with PTC admitted to and surgically treated at a single surgical center. We divided the patients into two groups according to age at PTC diagnosis: ≥55 years and <55 years. Results: We found that the rates of tumor progression, lymph node metastasis (LNM) and distant metastasis were significantly higher in patients ≥55 years than in those <55 years; consequently, TNM stages were significantly higher in older than in younger patients (p<0.05 for all parameters). The risk of tumor progression (T3+T4) was nearly two-fold higher and the risk of LNM (N1) more than four-fold higher in older than in younger patients (p<0.05 for both). No patients <55 years old but 19 patients >55 years old (9.8% of the total group) showed distant metastasis. The rates of microcalcification, vascular and capsular invasion, extrathyroidal extension, irregular tumor shape, multifocality, bilaterality and multiplicity of foci were significantly higher in older than in younger patients (p<0.05 for all). The rate of disease-free survival was significantly lower in older (86.6%) than in younger (98.7%) patients (p<0.0001), and the rate of overall survival was significantly lower in older (90.3%) than in younger (99.4%) patients (p<0.0001).Conclusions: PTC is more aggressive in patients aged ≥ 55 years than in their younger counterparts. This age therefore effectively stratifies PTC patients with a poor prognosis, indicating it is likely to be useful in clinical practice.

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Recurrence Factors and Characteristic Trends of Papillary Thyroid Cancer over Three Decades

International Journal of Endocrinology ◽

10.1155/2021/9989757 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Waralee Chatchomchuan ◽

Yotsapon Thewjitcharoen ◽

Krittadhee Karndumri ◽

Sriurai Porramatikul ◽

Sirinate Krittiyawong ◽

...

Keyword(s):

Thyroid Cancer ◽

Survival Rate ◽

Disease Free Survival ◽

Disease Specific Survival ◽

Papillary Thyroid ◽

Free Survival ◽

Factors Associated ◽

Disease Free ◽

Disease Specific

Background. The prevalence of thyroid cancer is rising worldwide. Although thyroid cancer has a favorable prognosis, up to 20% of patients experienced recurrent disease during the follow-up period. The present study aimed to examine the trend of incidence and factors associated with recurrence and outcomes of papillary thyroid cancer (PTC) in Thai patients over the last 30 years. Methods. We reviewed the clinical data of all patients with PTC who were treated between 1987 and 2019 at Theptarin Hospital. Clinical characteristics, epidemic trend, factors associated with the persistence/recurrence of the disease, overall disease-specific survival rate, and overall disease-free survival rate were analysed. Results. A total of 235 patients with PTC who were registered between 1987 and 2019 were reviewed. The mean age was 42.5 ± 14.3 years, with a mean follow-up of 9.5 years. Papillary thyroid microcarcinoma (PTMC) was consistently increased and accounted for 21.4% (50/235) of total cases. The American Thyroid Association (ATA) risk stratification was high in 24% of all PTMCs in the last decade, and 16.0% of these patients experienced local recurrence during the follow-up period. Coexistence with Hashimoto’s thyroiditis (HT) was found in one-fifth of the patients with PTC and was correlated with a low recurrence rate (HR: 0.16, P = 0.013 ). Only age ≥55 years associated with the persistence/recurrence of the disease. The overall disease-free survival and disease-specific survival rates were 77.4% and 98.3%, respectively. Conclusions. The prognosis of PTC is generally considered favorable. However, approximately one-fourth of patients with PTMC demonstrated more aggressive clinical behavior, particularly in the last decade of the study. Coexistence of HT contributed to a better prognosis.

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TREM1 fosters an immunosuppressive tumor microenvironment in papillary thyroid cancer

Endocrine Related Cancer ◽

10.1530/erc-21-0297 ◽

2021 ◽

Author(s):

Yang Zhao ◽

Cangang Zhang ◽

Yanan Zhu ◽

Xi Ding ◽

Yikun Zhou ◽

...

Keyword(s):

T Cells ◽

Thyroid Cancer ◽

Papillary Thyroid Cancer ◽

Molecular Mechanisms ◽

Methylation Status ◽

Disease Free Survival ◽

Papillary Thyroid ◽

Advanced Tumor ◽

Tumor Stages ◽

Immunosuppressive Microenvironment

The immunosuppressive microenvironment is associated with poor prognosis in papillary thyroid cancer (PTC); however, the molecular mechanisms involved are unknown. Among triggering receptor expressed on myeloid cell (TREM) family, we found that TREM1 expression in PTC was significantly higher than that in normal tissues. TREM1 overexpression was associated with BRAFV600E profiles and advanced tumor stages. Furthermore, TREM1 mRNA expression was negatively correlated with promoter methylation status. Specifically, hypomethylation of CpG site cg06196379 in the TREM1 promoter was related with poor patient disease free survival (DFS) and a high PTC recurrence rate. Mechanistically, TREM1 was mainly expressed in malignant epithelial cells but not macrophages in PTC by single-cell analysis. PTC tissues with high TREM1 levels had enhanced infiltration of regulatory T cells (Tregs) and decreased infiltration of CD8+ T cells. Our study confirms that hypomethylation-mediated overexpression of TREM1 in PTC cells promotes an immunosuppressive microenvironment by enhancing Treg infiltration. We recommend the future use of therapeutic strategy targeting TREM1 for the treatment of PTC.

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