IMP3, EGFR and E-Cadherin in High Grade Ovarian Serous Carcinomas To Predict Disease Progression and Survival
Devki Patel, Sambit K Mohanty, Kanwaljeet Singh, Christine Walsh, Elvio G Silva. Cedars-Sinai Medical Center, Los Angeles, CA; Harvard Medical School, Boston, MA
Background: Most high grade serous carcinomas (HGSCA) of ovary are advanced stage tumors with early recurrences. However, there are some unusual cases that do not recur and have excellent survival. This study aims to compare cases of HGSCA that showed rapid recurrences with those that did not recur, and also to evaluate the potential appropriateness of Epidermal Growth Factor Receptor (EGFR), E-cadherin and IMP3 to predict recurrence and survival.
Design: Thirty one cases of Stage III HGSCA were available for review satisfying our inclusion criteria (6 cycles of Taxol and carboplatin and < 1 cm of residual disease). Of the 31 cases, 17 recurred within 18 months follow-up and 14 cases did not recur (with a minimum follow-up of 49 months). The patterns of invasion, such as pushing and infiltrative, were assessed in all cases. The primary tumors were then subjected to a panel immunohistochemical (IPOX) marker such as IMP3, EGFR and E-cadherin. The staining results were recorded in semiquantitative fashion. Disease free survival (DFS) and overall survival (OS) of these cases were compared with the results of IPOX for individual stains using Log-rank test. Logistic regression analysis was performed to compare IPOX results of individual stains with recurrence status and with the pattern of invasion.
Results: Twenty one of 31 (67.7%) HGSCA expressed IMP3, 9 of 31 (29%) expressed EGFR and all cases expressed E-cadherin. The EGFR-negative tumors showed higher recurrence rate than EGFR-positive tumors. The cases with a higher percentage of destructive invasion showed higher IMP3 positivity and higher chances of recurrence whereas cases with higher percentage of pushing invasion showed lower IMP3 positivity and lower chances of recurrence (p=0.02). IMP3-negative tumors had lower odds of recurrence than IMP3-positive tumors (Odds Ratio: 0.1; 95%CI:0.016-0.615; p=0.01). Kaplan-Meier plots showed that patients with negative IMP3 staining had a significantly higher OS than those with IMP3 positive tumors (p=0.01).
Conclusions: - IMP3 may serve as a useful prognostic marker that can stratify patients of advanced stage, high grade serous carcinomas into two distinct subsets: majority with early recurrence (<24 months) with an infiltrative pattern of invasion and IMP3 positive; and a smaller subset that do not show disease recurrence for at least 49 months follow-up with pushing borders and IMP3 negative.
- IMP3-positive cases showed a significantly lower overall survival as compared to IMP3-negative tumors.
Category: Gynecologic & Obstetrics
Tuesday, March 20, 2012 9:30 AM
Poster Session III # 195, Tuesday Morning