P53 OVEREXPRESSION IN ADVANCED-STAGE ENDOMETRIAL ADENOCARCINOMA

OBJECTIVES: Mutation and overexpression of the p53 tumor suppressor ge ne in endometrial cancers are associated with advanced stage and poor survival. We sought to determine whether p53 overexpression is an inde pendent variable predictive of poor prognosis in advanced endometrial adenocarcinomas. STUDY DESIGN: Immunohistochemical evaluation was used to examine p53 expression in paraffin blocks from 179 endometrial ade nocarcinomas. RESULTS: p53 overexpression was seen in 35% of cancers a nd was associated with higher stage (p = 0.004), black race (p < 0.001 ), higher grade (p = 0.02), lack of hormone replacement (p = 0.04), an d older age (p = 0.05). In addition to a higher frequency of p53 overe xpression (57% vs 26%), black women had a lower survival rate than whi te women (p = 0.001), but overexpression was associated with poor surv ival in both races. After we corrected for hormone use, multivariate a nalysis revealed that older age (p < 0.001), higher stage (p < 0.001), higher grade (p = 0.01), and p53 overexpression (p = 0.04) were predi ctive of poor survival. CONCLUSIONS: Overexpression of p53 in advanced -stage endometrial cancers is an independent variable that is associat ed with poor survival, occurs more frequently in black women, and may contribute to the racial disparity in survival.