The association of the <i>BRAF</i>^V600E mutation with prognostic factors and poor clinical outcome in papillary thyroid cancer

<jats:title>Abstract</jats:title><jats:sec><jats:title>BACKGROUND:</jats:title><jats:p>The effects of the <jats:italic>BRAF</jats:italic><jats:sup>V600E</jats:sup> mutation on prognostic factors and poor clinical outcomes in papillary thyroid cancer (PTC) have not been fully quantified. The authors performed comprehensive meta‐analysis to assess the strength of associations between these conditions and the <jats:italic>BRAF</jats:italic><jats:sup>V600E</jats:sup> mutation.</jats:p></jats:sec><jats:sec><jats:title>METHODS:</jats:title><jats:p>The authors identified the clinical studies that examined the association of the <jats:italic>BRAF</jats:italic><jats:sup>V600E</jats:sup> mutation in surgical specimens with clinicopathologic outcomes between January 2003 and October 2010 using the Medline database. One hundred thirty‐one relevant studies were hand‐searched. The authors selected 27 studies that included 5655 PTC patients. They calculated the pooled odds ratios (ORs) or risk ratios with 95% confidence intervals (CIs) for each study using a random effect model.</jats:p></jats:sec><jats:sec><jats:title>RESULTS:</jats:title><jats:p>The average prevalence rate of the <jats:italic>BRAF</jats:italic><jats:sup>V600E</jats:sup> mutation was 49.4%. In 26 studies, compared with the patients who had the wild‐type <jats:italic>BRAF</jats:italic> genes, the PTC patients with the <jats:italic>BRAF</jats:italic><jats:sup>V600E</jats:sup> mutation had increased ORs of an extrathyroidal invasion (OR, 2.14; 95% CI, 1.68‐2.73), a lymph node metastasis (OR, 1.54; 95% CI, 1.21‐1.97), and an advanced TNM stage (OR, 2.00; 95% CI, 1.61‐2.49). In 8 studies, patients with the mutation had 2.14‐fold increased risk of recurrent and persistent disease (95% CI, 1.67‐2.74). The associations were generally consistent across the different study populations.</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS:</jats:title><jats:p>This meta‐analysis demonstrates that the <jats:italic>BRAF</jats:italic><jats:sup>V600E</jats:sup> mutation is closely related to the high‐risk clinicopathological factors and poorer outcome of PTC. The results obtained here suggest that the <jats:italic>BRAF</jats:italic><jats:sup>V600E</jats:sup> mutation should be considered as a poor prognostic marker in PTC and may lead to better management for individual patients. Cancer 2012;. © 2011 American Cancer Society.</jats:p></jats:sec>