Oncogene Expression: Long-Term Compared With Short-Term Survival in Patients With Advanced Epithelial Ovarian Cancer

Objective: To determine if oncogene overexpression in patients with advanced epithelial ovarian cancer correlates with survival. Methods: Twenty-two women with stage III ovarian cancer, observed for a median of 66 (range 48–204) months were compared with 30 with a median survival of 18 (range 2–28) months. Using immunocytochemistry, tumors were immunostained for overexpression of p53, c-erb-B-2, and epidermal growth factor receptor and were evaluated quantitatively for expression of estrogen receptor, progesterone receptor, and Ki-67 antigen, a marker of cellular proliferation. Results: The median age of long-term survivors was 52 (range 30–76) years compared with 55 (range 36–80) years for short-term survivors. Optimal cytoreduction was achieved in 11 of the 22 long-term survivors compared with seven of the 30 short-term survivors, a significant difference (P = .05). The average level of Ki-67 expression was 43% in long-term survivors and 64% in short-term survivors (P = .007). Overexpression of p53 was seen in 54% of long-term survivors and 80% of short-term survivors (P = .05). A combination of Ki-67 level of 50% or greater plus p53 overexpression was seen in 22% of long-term survivors compared with 68% of short-term survivors (P = .005). Epidermal growth factor receptor, c-erb-B-2, estrogen receptor, and progesterone receptor statuses did not differ significantly between the two groups. Conclusion: Markers that did not correlate with survival included the hormone receptors, estrogen receptor and progesterone receptor, and the oncogenes, c-erb-B-2 and epidermal growth factor receptor. Long-term survivors with advanced ovarian cancer were more likely to have had an optimal cytoreduction and lower levels of Ki-67 antigen expression and were less likely to overexpress p53 than were short-term survivors.