Document Detail

Wilms' tumor 1 protein and estrogen receptor beta expression are associated with poor outcomes in uterine carcinosarcoma.
MedLine Citation:
PMID:  23344579     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Uterine carcinosarcoma (CS) is an aggressive malignancy. Increased expression of Wilms' tumor 1 (WT1) protein and estrogen receptor beta (ER-β) protein is associated with worse outcomes in gynecologic cancers; therefore, we sought to assess this association in CS patients.
METHODS: A retrospective analysis was conducted for women diagnosed with uterine CS from departmental databases. WT1/ER-β expression was determined by immunohistochemical staining and scoring of specimens. Univariate and multivariate models were used to correlate progression-free survival (PFS) and overall survival (OS) with WT1/ER-β expression and clinicopathologic factors.
RESULTS: Ninety four patients had mean follow-up of 27 months. Postoperative treatments included chemotherapy for 52 (55 %) subjects and radiotherapy for 25 (27 %). Sixty-four (68 %) and 74 (79 %) tumor samples expressed WT1 and ER-β by immunohistochemistry, respectively. On univariate analysis, stage (p = .02) and lower uterine segment invasion (LUSI) (p = .001) were associated with decreased PFS. Only stage (p = .003) was linked to OS. In the total sample, increased WT1 expression was marginally associated with impaired PFS (p = .07) and OS (p = .09) but ER-β expression was not associated with PFS (p = .89) or OS (p = .30). WT1 and ER-β concurrent expression was associated with impaired OS (p = .02) and PFS (p = .02). On multivariate analysis, LUSI was a significant prognostic factor for PFS [hazard ratio (HR) 2.21, 95 % confidence interval (CI) = 1.12-4.32, p = .03] and stage for OS (HR 3.20, 95 % CI = 1.23-8.35, p = .02). Increased WT1/ER-β expression was associated with impaired OS (HR 1.31, 95 % CI = 1.02-1.69, p = .04).
CONCLUSIONS: Concurrent increased WT1 and ER-β expression impairs prognosis for women with uterine CS. Further research is warranted to define how relevant pathways interact and whether targeting these pathways improves OS.
Saketh R Guntupalli; Dengfeng Cao; Rupal Shroff; Feng Gao; Christine Menias; L Stewart Massad; Matthew A Powell; David G Mutch; Premal H Thaker
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Publication Detail:
Type:  Journal Article     Date:  2013-01-24
Journal Detail:
Title:  Annals of surgical oncology     Volume:  20     ISSN:  1534-4681     ISO Abbreviation:  Ann. Surg. Oncol.     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-06-07     Completed Date:  2013-12-17     Revised Date:  2014-11-14    
Medline Journal Info:
Nlm Unique ID:  9420840     Medline TA:  Ann Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2373-9     Citation Subset:  IM    
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MeSH Terms
Carcinosarcoma / metabolism*,  pathology*,  therapy
Chemotherapy, Adjuvant
Disease-Free Survival
Estrogen Receptor beta / metabolism*
Kaplan-Meier Estimate
Middle Aged
Multivariate Analysis
Neoplasm Invasiveness
Neoplasm Staging
Radiotherapy, Adjuvant
Retrospective Studies
Uterine Neoplasms / metabolism*,  pathology*,  therapy
WT1 Proteins / metabolism*
Grant Support
Reg. No./Substance:
0/Estrogen Receptor beta; 0/WT1 Proteins; 0/WT1 protein, human

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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