title: Overexpression of the epithelial cell adhesion molecule is associated with a more favorable prognosis and response to platinum-based chemotherapy in ovarian cancer.
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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Gynecology, European Competence Center for Ovarian Cancer, Campus Virchow Klinikum, Charité-University Medicine of Berlin, Berlin, Germany.
authors.forename: Hannah
authors.initials: H
authors.lastname: Woopen
authors.affiliation: Department of Gynecology, European Competence Center for Ovarian Cancer, Campus Virchow Klinikum, Charité-University Medicine of Berlin, Berlin, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Pietzner
authors.affiliation: Department of Gynecology, European Competence Center for Ovarian Cancer, Campus Virchow Klinikum, Charité-University Medicine of Berlin, Berlin, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Richter
authors.affiliation: Department of Gynecology, European Competence Center for Ovarian Cancer, Campus Virchow Klinikum, Charité-University Medicine of Berlin, Berlin, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Fotopoulou
authors.affiliation: Center for Anatomy, Charite Campus Mitte, Charite-University Medicine of Berlin, Berlin, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Joens
authors.affiliation: Department of Gynecology, European Competence Center for Ovarian Cancer, Campus Virchow Klinikum, Charité-University Medicine of Berlin, Berlin, Germany.
authors.forename: Elena Ioana
authors.initials: EI
authors.lastname: Braicu
authors.affiliation: Cancer Center Karolinska, Department of Oncology, Karolinska University Hospital Solna, Stockholm, Sweden.
authors.forename: Håkan
authors.initials: H
authors.lastname: Mellstedt
authors.affiliation: Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Mahner
authors.affiliation: TRION Research GmbH, Martinsried, Germany.
authors.forename: Horst
authors.initials: H
authors.lastname: Lindhofer
authors.affiliation: Institute of Pathology, Charité Campus Mitte, Charite-University Medicine of Berlin, Berlin, Germany.
authors.forename: Silvia
authors.initials: S
authors.lastname: Darb-Esfahani
authors.affiliation: Institute of Pathology, Charité Campus Mitte, Charite-University Medicine of Berlin, Berlin, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Denkert
authors.affiliation: Department of Gynecology, European Competence Center for Ovarian Cancer, Campus Virchow Klinikum, Charité-University Medicine of Berlin, Berlin, Germany.
authors.forename: Jalid
authors.initials: J
authors.lastname: Sehouli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000378:metabolism*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D016190:Carboplatin / Q000627:therapeutic use; D000077216:Carcinoma, Ovarian Epithelial; D015815:Cell Adhesion Molecules / Q000378:metabolism*; D000071858:Epithelial Cell Adhesion Molecule; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D009944:Organoplatinum Compounds / Q000627:therapeutic use*; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D017239:Paclitaxel / Q000627:therapeutic use; D011379:Prognosis; D014015:Tissue Banks; D016896:Treatment Outcome
chemical_list: D000951:Antigens, Neoplasm; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D015815:Cell Adhesion Molecules; C499379:EPCAM protein, human; D000071858:Epithelial Cell Adhesion Molecule; D009363:Neoplasm Proteins; D009944:Organoplatinum Compounds; D016190:Carboplatin; D017239:Paclitaxel
keywords: Epithelial cell adhesion molecule; Ovarian neoplasms; Survival