Precursor Lesions and Prognostic Factors in Primary Peritoneal Serous Carcinoma
Sandra L Lee, Gregg Nelson, Qiuli Duan, Anthony M Magliocco, Maire A Duggan. Foothills Medical Center, University of Calgary, Calgary, AB, Canada; Foothills Medical Center, Calgary, AB, Canada; University of Calgary, Calgary, AB, Canada; Lee Moffit Cancer Center, Tampa, FL
Background: Primary peritoneal serous carcinoma (PPSC) is uncommon and carcinogenetic and prognostic factors are incompletely described. Most pelvic high-grade serous carcinomas appear to originate in the fimbriated end of the fallopian tube as a serous tubal intraepithelial carcinoma (STIC) and later spread to involve the ovary and/or peritoneum. STIC may evolve from a p53 signature also found in the fimbriated end of the tube, and is termed a latent precursor since there is no morphological alteration of the epithelium. Some PPSC may also originate in the fallopian tube via the p53 signature-STIC-carcinoma pathway.
Design: Charts of 22 women with PPSC were reviewed for clinical and pathology data. Glass slides were reviewed for areas of PPSC, ovarian surface epithelium (OSE), ovarian cortical inclusion cysts (OCICs), normal tubal epithelium, tubal epithelial atypia (TEA), and serous tubal intraepithelial carcinoma (STIC). p53 and p16 immunohistochemical expression in these areas was compared for statistical associations and PPSC outcome was correlated with p53 and p16 expression and clinico-pathological variables.
Results: Mean age at presentation was 60 years. Most tumors were high grade, FIGO stage IIIc and treated by surgery and/or chemotherapy. Tubal pathology of STIC, TEA and/or p53 signatures occurred in 45.5% of tubes. p53 and p16 expression amongst PPSC and tubes were high and higher than OSE and OCICs. Differences in expression of p53 and p16 between all lesions were significant except for the p53 comparison of PPSC and fallopian tubes. Tubal pathology was more frequent in tubes with p53 overexpression (p<0.001), but did not associate with PPSC p53 or p16 expression. p53 and p16 expression amongst the OSE, and OCICs did not associate with PPSC expression. The median overall survival was 53 months and low grade tumors had a better prognosis (p=0.02).
Conclusions: A precursor role for p53 but not p16 related tubal pathology in the development of some PPSC was supported whereas a role for either antibody amongst OSE and OCICs was not. Tumor grade was the only significant prognostic factor.
Category: Gynecologic & Obstetrics
Wednesday, March 6, 2013 9:30 AM
Poster Session V # 178, Wednesday Morning