Abstract
BackgroundWT1 is a tumor suppressor gene responsible for Wilms' tumor. WT1 reactivity is limited to ovarian serous carcinomas. Recent studies have shown that WT1 plays an important role in the progression of disease and indicates a poorer prognosis of human malignancies such as acute myeloid leukemia and breast cancer. The aims of this study were to determine the survival and recurrence-free survival of women with advanced serous epithelial ovarian carcinoma in relation to WT1 gene expression.MethodsThe study accrued women over an 18-year period, from 1987–2004. During the study period, 163 patients were diagnosed with advanced serous epithelial ovarian carcinoma and had undergone complete post-operative chemotherapy, but the final study group comprised 99 patients. The records of these women were reviewed and the paraffin-embedded tissue of these women stained with WT1 immunostaining. Survival analysis was performed using Kaplan-Meier and Cox regression methods.ResultsFifty patients showed WT1 staining and forty-nine did not. Five-year survival of non-staining and staining groups were 39.4% and 10.7% (p < 0.00005); five-year recurrence-free survival of these groups were 29.8% and ≤ 7.5% (p < 0.00005), respectively. For survival the HR of WT1 staining, adjusted for residual tumor and chemotherapy response, was 1.98 (95% CI 1.28–3.79), and for recurrence-free survival the HR was 3.36 (95% CI 1.60–7.03). The HR for recurrence-free survival was not confounded by any other variables.ConclusionThis study suggests that expression of WT1 gene may be indicative of an unfavorable prognosis in patients with advanced serous epithelial ovarian carcinoma.
Highlights
WT1 is a tumor suppressor gene responsible for Wilms' tumor
The medical records of all women diagnosed with Federation of Gynecology and Obstetrics (FIGO) stage III and IV serous ovarian carcinoma in Department of Obstetrics and Gynecology, Songklanagarind Hospital, from January 1987 to December 2004, were retrospectively reviewed
We found that about 50% of advanced serous ovarian carcinoma patients were reactive for WT1
Summary
WT1 is a tumor suppressor gene responsible for Wilms' tumor. WT1 reactivity is limited to ovarian serous carcinomas. BMC Cancer 2006, 6:90 http://www.biomedcentral.com/1471-2407/6/90 cancer exist, approximately 60% are of the serous epithelial type [2] Due to their nonspecific initial symptoms, 70% of patients have widespread metastatic disease at the time of diagnosis [3]. Despite advances in evaluation and treatment, the survival rate for all stage of ovarian cancer has remained constant over the past 30 years [4]. Parameters such as International Federation of Gynecology and Obstetrics (FIGO) stage at diagnosis, histologic grade, cell type, and amount of residual disease after first surgery, represent the most important factors to date for distinguishing between those patients who will have favorable and unfavorable clinical outcomes. More recent various immunohistochemical studies of ovarian cancer have suggested that expression of particular markers may help in predicting outcome, and guide therapeutic choices [2,4,5,6,7,8]
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