Objectives: The purpose of the study was to analyze negative versus positive immunoexpression of epithelial cadherin (E-cadherin) and p53 in patients with primary advanced ovarian clear cell adenocarcinoma (OCCA) and its significance in relation to clinical features, progression-free survival and overall survival (OS).
Methods and Materials: Protein expression of E-cadherin and p53 was immunohistochemically evaluated in 61 OCCA patients with stages IIC to IV. The clinical factors studied included stage, age, CA-125, residual tumors, and chemotherapy regimens.
Results: Positive p53 immunoexpression was 44.8% (26/58) of OCCAs; in contrast, E-cadherin immunoexpression was observed in 75.9% (44/58) of OCCAs. The expected 5-year OS rate of OCCA treated with paclitaxel-based chemotherapy was significantly better than non-paclitaxel-based chemotherapy (40% vs 0%, P = 0.001). The expected 5-year OS rate of OCCA patients with positive E-cadherin immunoexpression (>10%) was also significantly better than patients with negative E-cadherin immunoexpression (≤10%) (35% vs 0%, P = 0.02). The expected 5-year OS rate of those receiving paclitaxel-platinum chemotherapy was not significantly different from platinum-based chemotherapy for those with negative E-cadherin immunoexpression (P = 0.11). The expected 5-year OS rate of those receiving paclitaxel-based chemotherapy was better than non-paclitaxel-based chemotherapy for those with positive E-cadherin immunoexpression (43% vs 0%, P = 0.01). Paclitaxel-based chemotherapy and positive E-cadherin immunoexpression were 2 independent prognostic factors in OS of patients with OCCA (P = 0.01 and 0.04, respectively).
Conclusions: E-cadherin is a useful prognostic marker for OCCA patients, and paclitaxel-based chemotherapy can improve survival among patients with positive E-cadherin immunoreactivity.
*Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Cathay General Hospital; †School of Medicine, Fu Jen Catholic University, Hsinchuang, Taipei Hsien; ‡School of Medicine, Taipei Medical University; Departments of §Obstetrics and Gynecology and ∥Pathology, National Taiwan University Hospital; ¶Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, and #Department of Pathology, Cathay General Hospital; **Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung; ††Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung; ‡‡Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Tri-Service General Hospital; and §§Department of Pathology, Mackay Memorial Hospital, Taipei, Taiwan.
Received January 10, 2010, and in revised form March 23, 2010.
Accepted for publication May 6, 2010.
Address correspondence and reprint requests to Chang-Yao Hsieh, MD, MSPH, Department of Obstetrics and Gynecology, National Taiwan University Hospital, 7 Chung-Shan S Rd, Taipei 100, Taiwan. E-mail: firstname.lastname@example.org.