979P - Predictive and prognostic role of survivin and p53 expression in patients with advanced ovarian cancer treated with neoadjuvant chemotherapy

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Ovarian Cancer
Translational Research
Presenter AGNIESZKA Gasowska-Bodnar
Authors A. Gasowska-Bodnar1, L. Bodnar2, M. Jerzak3, G. Wcisło2, M. Cichowicz4, A. Dąbek4, W. Kozłowski4, C. Szczylik2, W. Baranowski5
  • 1Department Of Gyneacologic Oncology, MIlitary Institute of Medicine, 04-141 - Warsaw/PL
  • 2Department Of Oncology, Military Institute of Medicine, 04-141 - Warsaw/PL
  • 3Department Of Gyneacology And Gyneacology Oncology, MIlitary Institute of Medicine, 04-141 - Warsaw/PL
  • 4Department Of Pathology, Military Institute of Medicine, 04-141 - Warsaw/PL
  • 5Department Of Gynecology And Gyneacology Oncology, MIlitary Institute of Medicine, 04-141 - Warsaw/PL

Abstract

Background

Qualification of patients with advanced ovarian cancer (AOC) to treatment with primary or interval debulking surgery (IDS) is the subject of controversy. The aim of this study was to assess the expressions of selected proteins of apoptosis to the effects of neoadjuvant chemotherapy (NAC) in patients with AOC.

Material and methods

We evaluated 60 consecutive patients with AOS (FIGO stage IIIC-IV) treated with NAC, retrospectively. Formalin-fixed, paraffin-embedded tissue specimens were immunohistochemically stained for expression of p53 and survivin in patients given platinum-based NAC undergoing IDS. The expression of survivin was adopted dichotomization by the median expression of the protein found total score (TS) equals 2. For low expression of survivin was TS ≤ 2, while high total score TS> 2 The positive and negative expression of p53 were used to dichotomization study group.

Results

Median age of 60 patients was 60 years. The optimal IDS was achieved in 69.1% (38/55). We observed significant difference in the percentage of stained nuclei (PS, p = 0.0002), the intensity of staining (IS, p = 0.0003) and TS (p = 0.0001) by comparing the expression of survivin in tumor tissue taken before and after NAC. The expression of p53 in tumor tissue before and after NAC was observed and significant difference was in PS, (p = 0.0424). There were no statistically significant difference in IS and the TS. Expression of survivin and p53 was not related to the results of IDS. Survivin expression was a prognostic factor in AOC patients treated with NAC (p = 0.0484). Expression of survivin and p53 proteins was not a predictor factor in AOC patients. Adverse factors affecting the PFS for AOC patients treated with NAC were: lack of optimal IDS and the lack of an objective response by RECIST criteria (respectively HR was 3.93 (95% CI, 2.07-7.46, p <0.0001 and 2.36 (95% CI, 1.25-4.47, p = 0.0080). Suboptimal range of IDS, resistance to platinum and lack of paclitaxel in the NAC were adverse prognostic factors [HR was appropriately 2.61 (1,17-5,83), p = 0.0188, 2.72 (1.07 - 6.89), p = 0.0353, and 2.56 (1,06-6,18), p = 0, 0358].

Conclusions

High expression of survivin is a useful prognostic factor in patients treated with neoadjuvant chemotherapy for advanced ovarian cancer. This effect is more significant in patients with positive expression of p53.

Disclosure

All authors have declared no conflicts of interest.