Among the top significantly mutated pathways were the cell cycle checkpoint pathway, including somatic variants of TP53, RAD9A, ATM, RFC4, ATR, PSMD3, ORC5, MCM6, and RPA1 (FDR = 2.98961e-8), and the p53 pathway, including somatic variants of TP53, ATM, ZMAT3, ATR, IGFBP3, and THBS1 (FDR = 6.76136e-8). These pathways are linked to proliferation and tumor carcinogenesis. Here, RFC4 is linked to neoplasm.