Article
作者: Menkiszak, Janusz ; Timpson, Paul ; Salfinger, Stuart ; Wu, Anna H. ; Li, Na ; Mittelstadt, Suzana ; Park, Sue K. ; Chiu, Derek S. ; Linder, Anna ; McInerny, Simone ; Berchuck, Andrew ; Brenton, James D. ; Cohen, Paul A. ; Boros, Jessica ; Doherty, Jennifer A. ; Ward, Robyn L. ; Kim, Jae-Hoon ; Steed, Helen ; Farrell, Rhonda ; Riggan, Marjorie J. ; Rao, Jianyu ; Leung, Yee ; Høgdall, Claus K. ; Alsop, Jennifer ; Kim, Jae-Weon ; Tan, Adeline ; Konecny, Gottfried E. ; Talhouk, Aline ; Gorringe, Kylie L. ; Hawkins, Nicholas J. ; Kelemen, Linda E. ; Campbell, Ian ; Pike, Malcolm C. ; Harris, Holly R. ; Anderson, Lyndal ; Cohen, Joshua ; Mateoiu, Constantina ; Lim, Belle W.X. ; Karlan, Beth Y. ; Beckmann, Matthias W. ; Bowtell, David D.L. ; Huzarski, Tomasz ; Park, Sang-Yoon ; Fasching, Peter A. ; Kommoss, Stefan ; Shah, Mitul ; Mahale, Sakshi ; Huntsman, David G. ; Orsulic, Sandra ; Stewart, Colin J.R. ; Jimenez-Linan, Mercedes ; Ramus, Susan J. ; Høgdall, Estrid ; Cheasley, Dane ; Jakubowska, Anna ; Koziak, Jennifer M. ; Mohan, Ganendra Raj ; Mallitt, Kylie-Ann ; DeFazio, Anna ; Gill, Anthony J. ; Köbel, Martin ; Pharoah, Paul D.P. ; Bolithon, Adelyn ; Schildkraut, Joellen M. ; Minoo, Parham ; Gronwald, Jacek ; Scott, Clare L. ; Friedlander, Michael L. ; Wakefield, Matthew ; Sung, Soseul ; James, Paul A. ; Wiedenhoefer, Rebekka ; Sundfeldt, Karin ; Pearson, John V. ; Ruebner, Matthias ; Pang, Chi Nam Ignatius ; Thorne, Heather ; Fischer, Anna ; Gourley, Charlie ; Lester, Jenny ; Tang, Katrina ; Grube, Marcel ; Erber, Ramona ; Cushing-Haugen, Kara L. ; Kim, Byoung-Gie ; Modugno, Francesmary ; Morris, David ; Hettiaratchi, Anusha ; Laslavic, Angela ; Liauw, Winston ; Pearce, Celeste Leigh ; Hartmann, Arndt ; Subramanian, Deepak ; Lai, Tiffany ; Klett, Kayla ; Crowe, Philip ; Quinn, Carmel M. ; Elishaev, Esther ; Lubiński, Jan ; Fu, Zhuxuan ; Harnett, Paul R. ; Gilks, Blake ; Brand, Alison H. ; Chezar, Ksenia ; Barlow, Ellen ; Kennedy, Catherine J. ; Meagher, Nicola S. ; Chou, Angela ; Staebler, Annette ; Anglesio, Michael S. ; Cybulski, Cezary
AbstractPurpose:Advanced-stage mucinous ovarian carcinoma (MOC) has poor chemotherapy response and prognosis and lacks biomarkers to aid stage I adjuvant treatment. Differentiating primary MOC from gastrointestinal (GI) metastases to the ovary is also challenging due to phenotypic similarities. Clinicopathologic and gene-expression data were analyzed to identify prognostic and diagnostic features.Experimental Design:Discovery analyses selected 19 genes with prognostic/diagnostic potential. Validation was performed through the Ovarian Tumor Tissue Analysis consortium and GI cancer biobanks comprising 604 patients with MOC (n = 333), mucinous borderline ovarian tumors (MBOT, n = 151), and upper GI (n = 65) and lower GI tumors (n = 55).Results:Infiltrative pattern of invasion was associated with decreased overall survival (OS) within 2 years from diagnosis, compared with expansile pattern in stage I MOC [hazard ratio (HR), 2.77; 95% confidence interval (CI), 1.04–7.41, P = 0.042]. Increased expression of THBS2 and TAGLN was associated with shorter OS in MOC patients (HR, 1.25; 95% CI, 1.04–1.51, P = 0.016) and (HR, 1.21; 95% CI, 1.01–1.45, P = 0.043), respectively. ERBB2 (HER2) amplification or high mRNA expression was evident in 64 of 243 (26%) of MOCs, but only 8 of 243 (3%) were also infiltrative (4/39, 10%) or stage III/IV (4/31, 13%).Conclusions:An infiltrative growth pattern infers poor prognosis within 2 years from diagnosis and may help select stage I patients for adjuvant therapy. High expression of THBS2 and TAGLN in MOC confers an adverse prognosis and is upregulated in the infiltrative subtype, which warrants further investigation. Anti-HER2 therapy should be investigated in a subset of patients. MOC samples clustered with upper GI, yet markers to differentiate these entities remain elusive, suggesting similar underlying biology and shared treatment strategies.