BRAF V600E mutation: Differential impact on central lymph node metastasis by tumor size in papillary thyroid carcinoma

Background The necessity of prophylactic central neck dissection is one of debating issues in the treatment of papillary thyroid carcinoma (PTC). In a previous study, the predictive value of BRAF mutation for lymph node metastasis was only significant in 0.5 to 1.0 cm PTC. Thus, we assess the predictive value of BRAF mutation for central lymph node metastasis according to tumor size. Methods Medical records of 3107 patients with PTC who underwent thyroidectomy with central neck dissection were retrospectively reviewed. Results BRAF mutation was a predictor for central lymph node metastasis in 2.0 to 4.0 cm PTC (odds ratio [OR] = 3.494; p =.002). Although BRAF mutation was associated with central lymph node metastasis in 0.5 to 1.0 cm PTC in univariate analysis (OR = 1.334; p =.047), this significance was not observed in multivariate analysis (OR = 1.232; p =.163). BRAF mutation was not associated with central lymph node metastasis in other tumor sizes. Conclusion Prophylactic central neck dissection could be considered in 2.0 to 4.0 cm PTC with positive BRAF mutation.