5574 Background: Ovarian carcinoma is the leading cause of death due to gynecologic malignancies, and age at the time of diagnosis has been suggested to predict for a poorer prognosis. However, few studies have determined if specific biomarkers can predict a difference in prognosis between younger and older patients. We have constructed a tissue microarray (TMA) with correlative clinical data comprised of cases of advanced papillary serous (PS) ovarian cancer to evaluate the features of ovarian cancer in the elderly. Methods: Two cohorts (patient’s age =65 and =55 at diagnosis) were identified by retrospective review of PS ovarian carcinoma pathology cases seen between 1999 and 2005. Patients with stage III or IV were included; those with BRCA mutations were excluded. A high density TMA (with 4 cores per primary tumor) was constructed, and sections were immunostained with ER, PR, and ErbB2. Clinical data were obtained by chart and database review; age, stage, and protein expression were then correlated with overall survival. Correlation of protein expression and age was also examined. Results: 154 cases were examined, with 74 cases in the =55 group and 80 cases in =65 group. There was no difference in survival between the 2 cohorts (p=0.42), but overall survival differed significantly between those patients diagnosed at =70 and >70 years of age (p=0.004). Tumors from the =65 cohort were more likely to express ER (66.7% ≥65, 44.1% ≤55; p=0.009) and less likely to express PR (34.7% ≥65, 57.1% ≤55; p=0.009). Only 3 cases in the older cohort, and none in the younger cohort, expressed ErbB2; these findings were not significant. Protein expression did not correlate with overall survival. However, multivariate analysis revealed that stage IIIc or IV disease (HR 2.38, p=0.04) and age>70 (HR 1.93, p=0.008) were independent risk factors for poorer outcome. Conclusions: This study suggests that patients with advanced PS ovarian carcinoma diagnosed at age >70 have poorer overall survival. PS ovarian cancer in older patients is more likely to express ER and less likely to express PR, but this does not correlate statistically with clinical outcome. Other characteristics of ovarian cancer in the elderly may account for their poorer prognosis, and this TMA will be a valuable tool to assess additional biomarkers. No significant financial relationships to disclose.
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