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

doi:10.1016/j.amjoto.2021.103278

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

^*Corresponding author for this work

Coller School of Management

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

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 language	English
Article number	103278
Journal	American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume	43
Issue number	3
DOIs	https://doi.org/10.1016/j.amjoto.2021.103278
State	Published - 1 May 2022

Keywords

Low risk
Markovian model
Thyroid carcinoma

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.amjoto.2021.103278

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

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.",

keywords = "Low risk, Markovian model, Thyroid carcinoma",

author = "Gilad Feinmesser and Raphael Feinmesser and Alon, {Eran E.} and Galit Avior and Moshe Leshno",

note = "Publisher Copyright: {\textcopyright} 2021 Elsevier Inc.",

year = "2022",

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doi = "10.1016/j.amjoto.2021.103278",

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AU - Feinmesser, Gilad

AU - Feinmesser, Raphael

AU - Alon, Eran E.

AU - Avior, Galit

AU - Leshno, Moshe

PY - 2022/5/1

Y1 - 2022/5/1

N2 - 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.

AB - 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.

KW - Low risk

KW - Markovian model

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IS - 3

M1 - 103278

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

Abstract

Keywords

UN SDGs

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