Clinical utility of BRAF and pTERT mutations in precision management of papillary thyroid cancer.

Papillary thyroid cancer is the most prevalent and indolent thyroid cancer, but still, around 20% of cases will develop regional recurrence or distant metastasis. Isolated or coexistent BRAF V600E and telomerase reverse transcriptase promotor (pTERT) mutations in thyroid cancer are associated with poor clinical outcomes. The prior knowledge of BRAF V600E and pTERT mutation may help to identify the cases that may recur or become refractory to standard radioactive iodine treatment. Such cases could be treated initially with complete disease eradication through extensive surgery followed by maximum permissible high-dose radioactive I-131 ablation and vigilant follow-up. Conventional risk assessment coupled with genotype-based risk assessment can help in the precise management of aggressive thyroid cancers. [ABSTRACT FROM AUTHOR]