VCP and ARF4 expression is associated with poorer survival and response to RAI. A, ARF4 (left) and VCP (right) expression in normal thyroid and PTC in the THCA TCGA data set. B, VCP expression in normal thyroid (n = 12), PDTC (n = 17), and ATC (n = 20). C, ARF4 (left) and VCP (right) expression in PTC with BRAF-like (n = 272) or RAS-like genetic signatures (n = 119). D, ARF4 expression in PTC with indicated genetic alterations. E, Frequency (%) of indicated genetic alterations in PTC with low (Q1Q2) versus high ARF4 (Q3Q4) expression. F and G, Same as D and E, but for VCP expression. H–J, DFS for THCA with high (Q3Q4; >12.71) versus low (Q1Q2; <12.71) VCP expression for the entire PTC cohort (H), RAI-treated patients (I) and non–RAI-treated patients (J). K, Hazard ratios ±95% CI for patients stratified on median VCP and ARF4 tumoral expression in THCA with the indicated treatment and genetic signature or alteration. L and M, DFS for THCA with high (Q3Q4; >11.84) versus low (Q1Q2; <11.84) ARF4 expression for RAI-treated PTC patients (L) and non–RAI-treated PTC patients (M). NS, not significant; *, P < 0.05; **, P < 0.01; ***, P < 0.001.