Abstract

Because the prognosis of melanoma is challenging and inaccurate when using current clinical approaches, clinicians are seeking more accurate molecular markers to improve risk models. Accordingly, we performed a survival analysis on 404 samples from The Cancer Genome Atlas (TCGA) cohort of skin cutaneous melanoma. Using our recently developed gene network model, we identified biological signatures that confidently predict the prognosis of melanoma (p-value < 10−5). Our model predicted 38 cases as low–risk and 54 cases as high–risk. The probability of surviving at least 5 years was 64% for low–risk and 14% for high–risk cases. In particular, we found that the overexpression of specific genes in the mitotic cell cycle pathway and the underexpression of specific genes in the interferon pathway are both associated with poor prognosis. We show that our predictive model assesses the risk more accurately than the traditional Clark staging method. Therefore, our model can help clinicians design treatment strategies more effectively. Furthermore, our findings shed light on the biology of melanoma and its prognosis. This is the first in vivo study that demonstrates the association between the interferon pathway and the prognosis of melanoma.

Highlights

  • Cutaneous melanoma is a malignancy of melanocytes

  • Hypergeometric tests revealed that the other two selected modules are associated with the mitotic cell cycle and the interferon (IFN) pathway, respectively [66] (S2 Fig)

  • According to the Cox model, overexpression of these genes is associated with poor prognosis, which is expected [68, 69]

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Summary

Introduction

Cutaneous melanoma is a malignancy of melanocytes. It is the most common type of skin cancer. The American Cancer Society estimates that over 73,000 new cases were diagnosed in 2015 in the United States and about 10,000 deaths are caused by melanoma each year [1]. The prognosis of melanoma is highly variable [2]. The 5–year overall survival rate can be as high as 97% for stage I and as low as 3% for stage IV [3, 4]. Almost all common treatment options for melanoma, including surgery, chemotherapy, and radiation therapy, have harmful and severe side effects. It is critical to identify patients who are not at a significant risk of metastasis and death due to the disease. The predictive power of clinical factors is limited [3, 5, 6]

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