Prognostic significance of p53 expression in advanced-stage ovarian serousborderline tumors

The purpose of this study was to investigate the frequency of p53 overexpre ssion in the primary ovarian tumors of patients with stages II and III sero us borderline tumors (SBTs) and to determine the relationship between p53 o verexpression and risk of progression/recurrence and survival, Of 112 patie nts with stages II-IV SBTs, paraffin-embedded tissue from the primary ovari an tumor was available in 68 cases. Immunohistochemical staining for p53 wa s performed. Clinical information was abstracted from the medical records. The major end points selected for analysis were time to progression/relapse , disease-free survival, overall survival, and cause-specific survival. Uni variate and multivariate regression analyses were also performed. The media n patient age was 37 years (range, 17-67 years). Twenty-two patients had st age II disease, and 46 had stage III disease. The mean follow-up time was 1 05 months. Nineteen patients (28%) had either disease progression (1 patien t) or relapse (18 patients). Eleven patients died: 10 patients died of thei r tumor, and 1 patient died of other causes. Thirteen cases (19%) had posit ive immunostaining for p53, Overexpression of p53 was significantly associa ted with an increased probability of progression/recurrence (P = 0.005) and a decreased overall survival (P = 0.012), After adjusting for age, Interna tional Federation of Gynecology and Obstetrics (FIGO) stage, the presence o f residual tumor, and the presence of invasive implants, patients whose tum ors overexpressed p53 had a 4-fold increased risk of progression/recurrence . Similarly, women whose tumor overexpressed p53 had an approximately 6-fol d increased risk of death. p53 overexpression in the ovarian tumors of pati ents with stage II and III SBTs is significantly associated with increased probability of relapse and decreased overall survival. This information sho uld provide better prognostic data to patients and their families and allow us to select patients who might benefit from postoperative treatment.