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Hormone-receptor expression and ovarian cancer survival: an Ovarian Tumor Tissue Analysis consortium study
- Source :
- The Lancet Oncology, The Lancet Oncology; Vol 14
- Publication Year :
- 2013
- Publisher :
- Elsevier BV, 2013.
-
Abstract
- Few biomarkers of ovarian cancer prognosis have been established, partly because subtype-specific associations might be obscured in studies combining all histopathological subtypes. We examined whether tumour expression of the progesterone receptor (PR) and oestrogen receptor (ER) was associated with subtype-specific survival.12 studies participating in the Ovarian Tumor Tissue Analysis consortium contributed tissue microarray sections and clinical data to our study. Participants included in our analysis had been diagnosed with invasive serous, mucinous, endometrioid, or clear-cell carcinomas of the ovary. For a patient to be eligible, tissue microarrays, clinical follow-up data, age at diagnosis, and tumour grade and stage had to be available. Clinical data were obtained from medical records, cancer registries, death certificates, pathology reports, and review of histological slides. PR and ER statuses were assessed by central immunohistochemistry analysis done by masked pathologists. PR and ER staining was defined as negative (1% tumour cell nuclei), weak (1 to50%), or strong (≥50%). Associations with disease-specific survival were assessed.2933 women with invasive epithelial ovarian cancer were included: 1742 with high-grade serous carcinoma, 110 with low-grade serous carcinoma, 207 with mucinous carcinoma, 484 with endometrioid carcinoma, and 390 with clear-cell carcinoma. PR expression was associated with improved disease-specific survival in endometrioid carcinoma (log-rank p0·0001) and high-grade serous carcinoma (log-rank p=0·0006), and ER expression was associated with improved disease-specific survival in endometrioid carcinoma (log-rank p0·0001). We recorded no significant associations for mucinous, clear-cell, or low-grade serous carcinoma. Positive hormone-receptor expression (weak or strong staining for PR or ER, or both) was associated with significantly improved disease-specific survival in endometrioid carcinoma compared with negative hormone-receptor expression, independent of study site, age, stage, and grade (hazard ratio 0·33, 95% CI 0·21-0·51; p0·0001). Strong PR expression was independently associated with improved disease-specific survival in high-grade serous carcinoma (0·71, 0·55-0·91; p=0·0080), but weak PR expression was not (1·02, 0·89-1·18; p=0·74).PR and ER are prognostic biomarkers for endometrioid and high-grade serous ovarian cancers. Clinical trials, stratified by subtype and biomarker status, are needed to establish whether hormone-receptor status predicts response to endocrine treatment, and whether it could guide personalised treatment for ovarian cancer.Carraresi Foundation and others.
- Subjects :
- Oncology
medicine.medical_specialty
endocrine system diseases
Serous carcinoma
Immunoenzyme Techniques
03 medical and health sciences
Ovarian tumor
0302 clinical medicine
Internal medicine
Biomarkers, Tumor
medicine
Humans
Mucinous carcinoma
Neoplasm Invasiveness
Neoplasm Staging
030304 developmental biology
Ovarian Neoplasms
0303 health sciences
Tissue microarray
business.industry
Ovary
Cancer
Middle Aged
Prognosis
medicine.disease
Adenocarcinoma, Mucinous
female genital diseases and pregnancy complications
Cystadenocarcinoma, Serous
3. Good health
Survival Rate
Serous fluid
Receptors, Estrogen
Tissue Array Analysis
Case-Control Studies
030220 oncology & carcinogenesis
Adenocarcinoma
Female
Neoplasm Grading
Receptors, Progesterone
business
Ovarian cancer
Carcinoma, Endometrioid
Adenocarcinoma, Clear Cell
Follow-Up Studies
Subjects
Details
- ISSN :
- 14702045
- Volume :
- 14
- Database :
- OpenAIRE
- Journal :
- The Lancet Oncology
- Accession number :
- edsair.doi.dedup.....5675b2aa48ebc00cb7a58356cc69519d