1. Is molecular testing in patients with low risk papillary thyroid carcinoma justified? A Markovian model.
- Author
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Feinmesser G, Feinmesser R, Alon EE, Avior G, and Leshno M
- Subjects
- Humans, Molecular Diagnostic Techniques, Retrospective Studies, Thyroid Cancer, Papillary genetics, Thyroid Cancer, Papillary pathology, Thyroid Cancer, Papillary surgery, Thyroidectomy, Carcinoma, Papillary genetics, Carcinoma, Papillary pathology, Carcinoma, Papillary surgery, Thyroid Neoplasms genetics, Thyroid Neoplasms pathology, Thyroid Neoplasms surgery
- 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., (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Published
- 2022
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