Impact of BRAF V600E Mutation on Event-Free Survival in Patients with Papillary Thyroid Carcinoma: A Retrospective Study in a Romanian Population.

We aimed to evaluate the prognostic value of BRAF V600E mutation in a series of 127 papillary thyroid carcinoma (PTC) cases as a single factor, and in synergic interaction with other standard risk factors. BRAF V600E mutation was assessed by real-time PCR. Event-free survival (EFS) was calculated between the date of the first evaluation and the date of occurrence of an adverse event or the date of the last known status. The prevalence of BRAF V600E mutation was 57.2%. The Kaplan-Meier analysis showed a significant reduction of EFS among cases harboring BRAF V600E mutation compared to non-mutated cases ( p = 0.010). In addition, BRAF V600E mutation was found to better predict adverse outcomes when associated with the following risk factors: age ≥ 55 years old ( p < 0.001), male gender ( p < 0.001), conventional ( p = 0.005) and tall cell ( p = 0.014) histology, tumor size > 40 mm ( p = 0.001), extrathyroidal extension ( p = 0.001), multifocality ( p = 0.001) and lymph node metastasis ( p < 0.001). In univariate analysis, a 3.74-fold increased risk for a reduced EFS ( p = 0.018) was found for BRAF V600E-mutated cases, but no increased risk was further confirmed by multivariate analysis. Our results highlight that BRAF V600E mutation cannot be used alone as an independent predictive factor in PTC patients, but is prognostically valuable if integrated in the context of other clinicopathological risk factors.