Differences in prognostic molecular markers between women over and under 45 years of age with advanced ovarian cancer

Purpose: The purpose of this study was to determine whether differences in molecular markers might explain the better prognosis of women less than or equal to45 years of age versus women >45 years of age diagnosed with ovarian cancers. Experimental Design: Tissue sections from women with stage III-IV ovarian cancers were examined for expression of CD34, p53, and HER2. The Kaplan-Meier method and Cox Proportional Hazard analyses were used to identify predictors for outcome. Results: Fifty-two women less than or equal to45 years of age were matched with 52 women who were >45 years old. Of the 44 available tissue sections, 24 were from the younger age group (mean age, 41 years), and 22 were from the older age group (mean age, 61 years). Based on CD34 expression, tumors from women >45 years of age had lower microvessel density (MVD) compared with tumors of younger women (10.3 versus 16.1 microvessels per x 400 field; P = 0.03). Lower MVD (less than or equal to11 microvessels per x 400 field) predicted for a worse prognosis than higher MVD (>11 microvessels per x 400 field) in the overall study group (P = 0.001) and within the older subgroup (P = 0.03). The expressions of p53 (P = 0.13) and HER2 (P = 0.49) did not vary between the two age groups. The median survivals of those with tumors that overexpressed p53 and HER2 were 28.6 and 23.9 months compared with 51.7 and 38.6 months in those with cancers that underexpressed these markers, respectively (P = 0.09 for p53, P = 0.15 for HER2). Conclusions: Ovarian cancers in women >45 years of age had lower MVD compared with those in women less than or equal to45 years of age. Lower MVD was an independent prognostic factor for decreased survival. Lower frequency of neovascularization in these cancers may contribute to the decreased survival observed in women >45 years of age.