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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2020
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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. |
format | Online Article Text |
id | pubmed-8087602 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
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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