Journal
NATURE MEDICINE
Volume 16, Issue 7, Pages 781-U81Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/nm.2174
Keywords
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Funding
- French Institut National du Cancer
- French Projets Hospitaliers de Recherche Clinique program
- European Connective Tissue Cancer Network
- Curie Institute
- Bergonie Cancer Institute
- l'INSERM
- French Ligue Nationale Contre le Cancer
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Sarcomas are heterogeneous and aggressive mesenchymal tumors. Histological grading has so far been the best predictor for metastasis-free survival, but it has several limitations, such as moderate reproducibility and poor prognostic value for some histological types. To improve patient grading, we performed genomic and expression profiling in a training set of 183 sarcomas and established a prognostic gene expression signature, complexity index in sarcomas (CINSARC), composed of 67 genes related to mitosis and chromosome management. In a multivariate analysis, CINSARC predicts metastasis outcome in the training set and in an independent 127 sarcomas validation set. It is superior to the Federation Francaise des Centres de Lutte Contre le Cancer grading system in determining metastatic outcome for sarcoma patients. Furthermore, it also predicts outcome for gastrointestinal stromal tumors (GISTs), breast carcinomas and lymphomas. Application of the signature will permit more selective use of adjuvant therapies for people with sarcomas, leading to decreased iatrogenic morbidity and improved outcomes for such individuals.
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