Wang F, et al. - In the present study, researchers tested whether, in papillary thyroid cancer (PTC), the prognostic risk of male sex was determined by BRAF V600E and can thus be stratified by BRAF status. Findings from the present study suggested that male sex is a strong independent risk factor for PTC-specific mortality in BRAF V600E patients, but not in wild-type BRAF patients. In clinical application, the prognostic risk of male sex in PTC can be stratified by BRAF status.

Methods

• For this investigation, researchers retrospectively examined the connection between male sex and clinicopathologic outcomes in PTC, especially mortality, with respect to BRAF status in 2,638 subjects (male, n = 623; female, n = 2,015) from 11 centers in six countries, with median age of 46 years (interquartile range, 35-58 years) at diagnosis and median follow-up time of 58 months (interquartile range, 26-107 months).

Results

• According to the findings, distant metastasis rates in men and women were not different in wild-type BRAF PTC, but were different in BRAF V600E PTC: 8.9% (24 of 270) and 3.7% (30 of 817; P=.001), respectively.
• Mortality rates were 1.4% (five of 349) vs 0.9% (11 of 1175) in men vs women (P=.384), with a hazard ratio (HR) of 1.59 (95% CI, 0.55 to 4.57), which remained insignificant at 0.70 (95% CI, 0.23 to 2.09) after clinicopathologic multivariable adjustment in wild-type BRAF PTC.
• Mortality rates were 6.6% (18 of 272) vs 2.9% (24 of 822) in men vs women (P=.006), with an HR of 2.43 (95% CI, 1.30 to 4.53), which remained significant at 2.74 (95% CI, 1.38 to 5.43) after multivariable adjustment in BRAF V600E PTC.
• Male sex similarly had no impact in wild-type BRAF patients in conventional-variant PTC.
• Mortality rates in BRAF V600E patients were 7.2% (16 of 221) vs 2.9% (19 of 662) in men vs women (P=.004), with an HR of 2.86 (95% CI, 1.45 to 5.67), which remained significant at 3.51 (95% CI, 1.62 to 7.63) after multivariable adjustment.