Clinicopathologic Analysis of Low Stage Sporadic Ovarian Carcinoma.
Yevgeniy Karamurzin, Mario Leitao, Daniel Chiapetta, David Marshal, Robert Soslow. Memorial Sloan-Kettering Cancer Center, New York, NY
Background: In 2004 we reported data emphasizing the prognostic value of TP53 mutation in FIGO stage I and II ovarian carcinoma (low stage OC). However, tumor histologic subtype, grade, and substage did not correlate with 5-year progression-free or overall survival in this cohort; and TP53 mutation status was not strongly associated with cell type. We hypothesized that histologic recalibration of these tumors using criteria proposed by Gilks et al. would disclose closer associations between pathologic findings and prognosis.
Design: The cohort comprised 91 previously identified patients with low stage OC who underwent primary surgical management at our institution from 1980 to 2000. H&E slides were reviewed and histologic type reassigned using Gilks et al. criteria. p53 and WT1 expression was evaluated using standard immunohistochemistry (IHC) techniques on a tissue microarray. Direct TP53 gene sequencing of the entire coding region was performed on all cases with available tissue. Relationships between survival and the following parameters were studied: histologic type, grade, presence of endometriosis, substage, p53 and WT1 expression, and TP53 mutation. Tumors from known BRCA1 and 2 carriers were excluded.
Results: Endometrioid histology and presence of associated pelvic (tubal, peritoneal, or ovarian) endometriosis conferred favorable disease specific (DSS) and progression free survival (PFS) advantage. The presence of TP53 mutation was prognostically unfavorable for PFS. The findings are summarized in Table1. The other parameters were not statistically associated with survival in this cohort.
|10-year overall survival (OS)||83.1||60.4||73.4||58.7||77.2||55.2|
|10-year disease specific survival (DSS)||91.8||62||75.7||58.7||79.5||59.4|
|10 -year progression free survival (PFS)||92||60.5||76.2||45.7||77.7||59.7|