J Gynecol Oncol.  2014 Jul;25(3):221-228. 10.3802/jgo.2014.25.3.221.

Overexpression of the epithelial cell adhesion molecule is associated with a more favorable prognosis and response to platinum-based chemotherapy in ovarian cancer

• Woopen H
• Pietzner K
• Richter R
• Fotopoulou C
• Joens T
• Braicu EI
• Mellstedt
• Mahner S
• Lindhofer
• Darb-Esfahani S
• Denkert C
• Sehouli J

• KMID: 2130103
• DOI: http://doi.org/10.3802/jgo.2014.25.3.221

Abstract

OBJECTIVE
Epithelial cell adhesion molecule (EpCAM) has experienced a renaissance lately as a binding site for targeted therapy as well as a prognostic marker in epithelial malignancies. Aim of this study was to study EpCAM as a potential prognostic marker in epithelial ovarian cancer (EOC).
METHODS
EpCAM expression was assessed by immunohistochemistry on paraffin-embedded primary EOC-tissue samples. EpCAM overexpression was defined as an expression of EpCAM of 76% to 100%. Tissue samples and clinical data were systematically collected within the international and multicenter "Tumorbank Ovarian Cancer" network.
RESULTS
Seventy-four patients, diagnosed with EOC between 1994 and 2009, were included in the study (median age, 56 years; range, 31 to 86 years). The majority of the patients (81.1%) presented with an advanced stage International Federation of Gynecology and Obstetrics (FIGO) III/IV disease. Histology was of the serous type in 41 patients (55.4%), endometrioid in 19 (25.6%), and mucinous in 14 (19%). EpCAM was overexpressed in 87.7%. Serous tumors overexpressed EpCAM significantly more often than mucinous tumors (87.8% vs. 78.6%, p=0.045); while no significant difference was noted between the other histological subgroups. EpCAM overexpression was significantly associated with a better progression free survival and higher response rates to platinum based chemotherapy (p=0.040 and p=0.048, respectively). EpCAM was identified as an independent prognostic marker for overall survival (p=0.022).
CONCLUSION
Our data indicate a significant association of EpCAM overexpression with a more favorable survival in EOC-patients. Serous cancers showed a significant EpCAM overexpression compared to mucinous types. Larger multicenter analyses are warranted to confirm these findings.

Keyword

Epithelial cell adhesion molecule; Ovarian neoplasms; Survival

MeSH Terms

Adult
Aged
Aged, 80 and over
Antigens, Neoplasm/*metabolism
Antineoplastic Agents/*therapeutic use
Carboplatin/therapeutic use
Cell Adhesion Molecules/*metabolism
Female
Humans
Kaplan-Meier Estimate
Middle Aged
Neoplasm Proteins/metabolism
Neoplasm Staging
Neoplasms, Glandular and Epithelial/*diagnosis/drug therapy/pathology
Organoplatinum Compounds/*therapeutic use
Ovarian Neoplasms/*diagnosis/drug therapy/pathology
Paclitaxel/therapeutic use
Prognosis
Tissue Banks
Treatment Outcome
Tumor Markers, Biological/*metabolism
Antigens, Neoplasm
Antineoplastic Agents
Carboplatin
Cell Adhesion Molecules
Neoplasm Proteins
Organoplatinum Compounds
Tumor Markers, Biological
Paclitaxel

Figure

• 

  Fig. 1 Immunohistochemistry staining for epithelial cell adhesion molecule (EpCAM). (A) Mucinous ovarian cancer; bar 100 µm. (B) Endometrioid ovarian cancer; bar 50 µm. (C) Serous ovarian cancer; bar 100 µm. (D) Demonstration of the membranous staining of EpCAM, example extracted from panel C; bar 20 µm.

• 

  Fig. 2 Overall survival illustrated for patients with different epithelial cell adhesion molecule (EpCAM) expression rates (n=74).

• 

  Fig. 3 Progression free survival illustrated for patients with different epithelial cell adhesion molecule (EpCAM) expression rates (n=74).

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