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Using The Cancer Genome Atlas data to refine the 8th edition of the American Joint Committee on Cancer staging for papillary thyroid carcinoma

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 Genom...

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Autores principales: Poma, Anello Marcello, Macerola, Elisabetta, Torregrossa, Liborio, Elisei, Rossella, Santini, Ferruccio, Basolo, Fulvio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087602/
https://www.ncbi.nlm.nih.gov/pubmed/32915437
http://dx.doi.org/10.1007/s12020-020-02434-x
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author Poma, Anello Marcello
Macerola, Elisabetta
Torregrossa, Liborio
Elisei, Rossella
Santini, Ferruccio
Basolo, Fulvio
author_facet Poma, Anello Marcello
Macerola, Elisabetta
Torregrossa, Liborio
Elisei, Rossella
Santini, Ferruccio
Basolo, Fulvio
author_sort Poma, Anello Marcello
collection PubMed
description 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.
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spelling pubmed-80876022021-05-05 Using The Cancer Genome Atlas data to refine the 8th edition of the American Joint Committee on Cancer staging for papillary thyroid carcinoma Poma, Anello Marcello Macerola, Elisabetta Torregrossa, Liborio Elisei, Rossella Santini, Ferruccio Basolo, Fulvio Endocrine Original Article 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. Springer US 2020-09-11 2021 /pmc/articles/PMC8087602/ /pubmed/32915437 http://dx.doi.org/10.1007/s12020-020-02434-x Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Poma, Anello Marcello
Macerola, Elisabetta
Torregrossa, Liborio
Elisei, Rossella
Santini, Ferruccio
Basolo, Fulvio
Using The Cancer Genome Atlas data to refine the 8th edition of the American Joint Committee on Cancer staging for papillary thyroid carcinoma
title Using The Cancer Genome Atlas data to refine the 8th edition of the American Joint Committee on Cancer staging for papillary thyroid carcinoma
title_full Using The Cancer Genome Atlas data to refine the 8th edition of the American Joint Committee on Cancer staging for papillary thyroid carcinoma
title_fullStr Using The Cancer Genome Atlas data to refine the 8th edition of the American Joint Committee on Cancer staging for papillary thyroid carcinoma
title_full_unstemmed Using The Cancer Genome Atlas data to refine the 8th edition of the American Joint Committee on Cancer staging for papillary thyroid carcinoma
title_short Using The Cancer Genome Atlas data to refine the 8th edition of the American Joint Committee on Cancer staging for papillary thyroid carcinoma
title_sort using the cancer genome atlas data to refine the 8th edition of the american joint committee on cancer staging for papillary thyroid carcinoma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087602/
https://www.ncbi.nlm.nih.gov/pubmed/32915437
http://dx.doi.org/10.1007/s12020-020-02434-x
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