Steroid hormone receptors and long term survival in invasive ovarian cancer

BACKGROUND. Steroid hormone receptors are important determinants of prognos is and predictive behavior in tumor tissues of several origins. Since their role in (ER+PR+, ER+PR-, ER-PR+, and ER-PR-) in a comparably large number of patients with a long clinical follow-up. METHODS. The present analysis included 186 patients with invasive ovarian c arcinomas treated at the Department of Obstetrics and Gynecology of the Jus tus-Liebig-University Giessen between 1982 and 1996, the follow-up lasting up to 15.8 years (median 2.4 yrs). The expression of ER and PR was assessed by immunohistochemistry using alkaline phosphatase antialkaline phosphatas e in microwave pretreated, formalin fixed, and paraffin embedded specimens of the primary tumors;md was evaluated semiquantitatively using a standardi zed immunoreactive scoring system. Receptor expression and combinations wer e compared to clinical, histologic and prognostic factors, the tumor prolif eration, and the clinical outcome. RESULTS. Kaplan-Meier survival analyses supported the favorable prognostic value of PR and its level of expression in ovarian carcinomas. Especially t he ER-PR+ combination, which accounted for 10.2% of all tumors, showed a si gnificantly superior prognosis when compared with all other combinations (s urvivors 15 of 19 vs. 67 of 167, log rank P = 0.009) and was associated wit h early stage, low ascites quantity, and higher tumor differentiation. Five -year survival rates were 13/16 (81.3%) for ER-PR+ tumors versus 58/128 (45 .3%) for all other steroid hormone receptor combinations. Residual analysis proved the results. CONCLUSIONS, The determination of steroid hormone receptor status offers ad ditional prognostic information in ovarian carcinomas. Especially the ER-PR + phenotype predicts a favorable tumor biology and long term survival, prob ably reflecting functional effects on tumor proliferation, differentiation, and cellular apoptosis. Cancer 2000;89:1783-91. (C) 2000 American Cancer S ociety.