Thyroid cancer staging and genomics

Journal of Surgery about staging of thyroid cancer and implications of genomic analysis based on patients' age (1).The authors compared overall survival and recurrencefree survival with different age cutoff values, and they investigated the appropriateness of the new staging system at a genomic level.They studied 505 patients for the clinical information (low-to intermediate-risk papillary thyroid cancers with 28 recurrences and 14 deaths) and The Cancer Genome Atlas (TCGA) data.They were able to show significant values using 55 years as a cutoff for relapse-free survival.Signaling pathway analysis revealed that patients above age 55 had differing genetic pathways associated with aggressiveness of thyroid cancer.The authors also compared gene expression data, altered canonical pathways, copy number alteration, and somatic mutation profiles according to patient's age distributions to investigate differences in the new staging system on a genomic level.Ingenuity Pathways Analysis showed that patients above age 55 had alterations in Sirtuin signaling pathway, MSP-RON signaling pathway, ATM signaling, and FXR/RXR activation pathway, and TGF-beta pathway.They were not able to show a difference in copy number alteration or somatic mutation patterns between various age groups.They were also not able to show statistically significant frequency differences of somatic mutation or copy number alteration.In their multi-platform analysis, they reported that 14 age specific genes below the age of 45 and no age specific genes in the age group from 45 to 54 (age specific genes identified by multiple t-testing with P<0.001 and >1.5 difference).Compared to patients below age 55,