Is molecular testing in patients with low risk papillary thyroid carcinoma justified? A Markovian model

Gilad Feinmesser, Raphael Feinmesser, Eran E. Alon, Galit Avior, Moshe Leshno

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Current guidelines consider all cases of papillary thyroid carcinoma (PTC) smaller than 4 cm and without extrathyroidal extension (ETE) and/or lymph node metastases as belonging to the same prognostic group, and therefore the recommendation is for uniform treatment. Xing draws our attention to a small subgroup with Duet Mutations (BRAF E600 and TERT 3636 genes) that are aggressive biologically and should be treated differently. Thus the aim of the present study is to test the validity of this recommendation. Methods: A Markovian Model is used to evaluate the above hypothesis. Results: A Monte Carlo sensitivity test shows a 5.6 year survival advantage for patients with low-grade PTC, who have the Duet Mutations, and were treated by total thyroidectomy rather than hemithyroidectomy. Conclusions: We conclude that there is a place for routine molecular tests in low-risk patients with PTC.

Original languageEnglish
Article number103278
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume43
Issue number3
DOIs
StatePublished - 1 May 2022

Keywords

  • Low risk
  • Markovian model
  • Thyroid carcinoma

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