Using The Cancer Genome Atlas data to refine the 8th edition of the American Joint Committee on Cancer staging for papil
- PDF / 958,406 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 70 Downloads / 163 Views
ORIGINAL ARTICLE
Using The Cancer Genome Atlas data to refine the 8th edition of the American Joint Committee on Cancer staging for papillary thyroid carcinoma Anello Marcello Poma1 Elisabetta Macerola1 Liborio Torregrossa2 Rossella Elisei3 Ferruccio Santini3 Fulvio Basolo1 ●
●
●
●
●
1234567890();,:
1234567890();,:
Received: 5 May 2020 / Accepted: 21 July 2020 © The Author(s) 2020
Abstract Purpose The 8th edition of the American Joint Committee on Cancer (AJCC) staging led to a significant downstaging of well differentiated thyroid cancer patients. However, some patients who had been downstaged still experienced death. By using data from the thyroid cancer dataset of The Cancer Genome Atlas (TCGA), we aimed to find molecular features that could improve survival prediction. Methods TCGA data were downloaded from cBioPortal. Restaging of cases was performed according to the pathological reports. Results Out of 496 cases, 204 (41.1%) were downstaged, and the proportion of deaths increased in stages III and IV. TERT promoter mutations were no longer enriched in stage IV only, but significantly redistributed also in stages II and III. TERT mutation was the only alteration predictive of poor survival; however, in this series it was not independent from the AJCC staging. Five proteins (4E-BP1_pT70, Chk1_pS345, Snail, STAT5 alpha and PAI-1) were significantly associated with survival, and their use as a panel refined the risk stratification independently from the AJCC staging, with a hazard ratio for a positive result of 21.2 (95%CI 3.7–122.2, P = 0.0006). Conclusions In the TCGA series, the proportion of deaths is in line with the expected survival of the latest AJCC staging, with a neat separation of risk among stages. Nevertheless, the use of protein expression can be useful in refining the stratification. Finally, after the restaging, a considerable number of tumors with TERT mutations will be allocated in lower stages; hence, dedicated studies should define the prognostic usefulness of these mutations in low-stage diseases. Keywords AJCC staging Papillary Thyroid Carcinoma PTC TCGA data Prognosis Outcome ●
●
Introduction The American Joint Committee on Cancer (AJCC) tumornode-metastasis staging is the most effective and used
* Fulvio Basolo [email protected] 1
Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Via Savi 10, 56126 Pisa, Italy
2
Department of Laboratory Medicine, Section of Pathology, University Hospital of Pisa, Via Roma 57, 56126 Pisa, Italy
3
Department of Clinical and Experimental Medicine, Unit of Endocrinology, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy
●
●
●
stratification system designed to predict survival of patients. The 8th edition of the AJCC staging for thyroid cancer was released at the end of 2016 but is effective from the beginning of 2018. With respect to the 7th edition, the main changes for well differentiated thyroid cancer (WDTC) were: (i) the increase of the age cutoff from 45 to 55 years, (ii) the redefinition o
Data Loading...
