A meta-analysis of prognostic roles of molecular markers in papillary thyroid carcinoma

Huy Gia Vuong, Uyen N P Duong, Ahmed M A Altibi, Hanh T T Ngo, Thong Quang Pham, Hung Minh Tran, Greta Gandolfi, Lewis Hassell

Research output: Contribution to journalReview article

Abstract

The prognostic role of molecular markers in papillary thyroid carcinoma (PTC) is a matter of ongoing debate. The aim of our study is to investigate the impact of RAS, BRAF, TERT promoter mutations and RET/PTC rearrangements on the prognosis of PTC patients. We performed a search in four electronic databases: PubMed, Scopus, Web of Science and Virtual Health Library (VHL). Data of hazard ratio (HR) and its 95% confidence interval (CI) for disease-specific survival (DSS) and disease-free survival (DFS) were directly obtained from original papers or indirectly estimated from Kaplan-Meier curve (KMC). Pooled HRs were calculated using random-effect model weighted by inverse variance method. Publication bias was assessed by using Egger's regression test and visual inspection of funnel plots. From 2630 studies, we finally included 35 studies with 17,732 patients for meta-analyses. TERT promoter mutation was significantly associated with unfavorable DSS (HR = 7.64; 95% CI = 4.00-14.61) and DFS (HR = 2.98; 95% CI = 2.27-3.92). BRAF mutations significantly increased the risk for recurrence (HR = 1.63; 95% CI = 1.27-2.10) but not for cancer mortality (HR = 1.41; 95% CI = 0.90-2.23). In subgroup analyses, BRAF mutation only showed its prognostic value in short-/medium-term follow-up. Data regarding RAS mutations and RET/PTC fusions were insufficient for meta-analyses. TERT promoter mutation can be used as an independent and reliable marker for risk stratification and predicting patient's outcomes. The use of BRAF mutation to assess patient prognosis should be carefully considered.

Original languageEnglish
Pages (from-to)R8-R17
JournalEndocrine Connections
Volume6
Issue number3
DOIs
Publication statusPublished - Apr 2017

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Meta-Analysis
Mutation
Confidence Intervals
Disease-Free Survival
Digital Libraries
Publication Bias
Survival
Papillary Thyroid cancer
PubMed
Databases
Recurrence
Mortality
Health
Neoplasms

Keywords

  • Journal Article
  • Review

Cite this

Vuong, H. G., Duong, U. N. P., Altibi, A. M. A., Ngo, H. T. T., Pham, T. Q., Tran, H. M., ... Hassell, L. (2017). A meta-analysis of prognostic roles of molecular markers in papillary thyroid carcinoma. Endocrine Connections, 6(3), R8-R17. https://doi.org/10.1530/EC-17-0010

A meta-analysis of prognostic roles of molecular markers in papillary thyroid carcinoma. / Vuong, Huy Gia; Duong, Uyen N P; Altibi, Ahmed M A; Ngo, Hanh T T; Pham, Thong Quang; Tran, Hung Minh; Gandolfi, Greta; Hassell, Lewis.

In: Endocrine Connections, Vol. 6, No. 3, 04.2017, p. R8-R17.

Research output: Contribution to journalReview article

Vuong, HG, Duong, UNP, Altibi, AMA, Ngo, HTT, Pham, TQ, Tran, HM, Gandolfi, G & Hassell, L 2017, 'A meta-analysis of prognostic roles of molecular markers in papillary thyroid carcinoma', Endocrine Connections, vol. 6, no. 3, pp. R8-R17. https://doi.org/10.1530/EC-17-0010
Vuong, Huy Gia ; Duong, Uyen N P ; Altibi, Ahmed M A ; Ngo, Hanh T T ; Pham, Thong Quang ; Tran, Hung Minh ; Gandolfi, Greta ; Hassell, Lewis. / A meta-analysis of prognostic roles of molecular markers in papillary thyroid carcinoma. In: Endocrine Connections. 2017 ; Vol. 6, No. 3. pp. R8-R17.
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AU - Altibi, Ahmed M A

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AU - Pham, Thong Quang

AU - Tran, Hung Minh

AU - Gandolfi, Greta

AU - Hassell, Lewis

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AB - The prognostic role of molecular markers in papillary thyroid carcinoma (PTC) is a matter of ongoing debate. The aim of our study is to investigate the impact of RAS, BRAF, TERT promoter mutations and RET/PTC rearrangements on the prognosis of PTC patients. We performed a search in four electronic databases: PubMed, Scopus, Web of Science and Virtual Health Library (VHL). Data of hazard ratio (HR) and its 95% confidence interval (CI) for disease-specific survival (DSS) and disease-free survival (DFS) were directly obtained from original papers or indirectly estimated from Kaplan-Meier curve (KMC). Pooled HRs were calculated using random-effect model weighted by inverse variance method. Publication bias was assessed by using Egger's regression test and visual inspection of funnel plots. From 2630 studies, we finally included 35 studies with 17,732 patients for meta-analyses. TERT promoter mutation was significantly associated with unfavorable DSS (HR = 7.64; 95% CI = 4.00-14.61) and DFS (HR = 2.98; 95% CI = 2.27-3.92). BRAF mutations significantly increased the risk for recurrence (HR = 1.63; 95% CI = 1.27-2.10) but not for cancer mortality (HR = 1.41; 95% CI = 0.90-2.23). In subgroup analyses, BRAF mutation only showed its prognostic value in short-/medium-term follow-up. Data regarding RAS mutations and RET/PTC fusions were insufficient for meta-analyses. TERT promoter mutation can be used as an independent and reliable marker for risk stratification and predicting patient's outcomes. The use of BRAF mutation to assess patient prognosis should be carefully considered.

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