Sex Steroid Hormone Receptor Expression Affects Ovarian Cancer Survival.
OBJECTIVE
Although most ovarian cancers express estrogen (ER), progesterone (PR), and androgen (AR) receptors, they are currently not applied in clinical decision making. We explored the prognostic impact of sex steroid hormone receptor protein and mRNA expression on survival in epithelial ovarian cancer.


METHODS
Immunohistochemical stainings for ERα, ERβ, PR, and AR were assessed in relation to survival in 118 serous and endometrioid ovarian cancers. Expression of the genes encoding the four receptors was studied in relation to prognosis in the molecular subtypes of ovarian cancer in an independent data set, hypothesizing that the expression levels and prognostic impact may differ between the subtypes.


RESULTS
Expression of PR or AR protein was associated with improved 5-year progression-free (P=.001 for both) and overall survival (P<.001 for both, log-rank test). ERα and ERβ did not provide prognostic information. Patients whose tumors coexpressed PR and AR had the most favorable prognosis, and this effect was retained in multivariable analyses. Analyses of the corresponding genes using an independent data set revealed differences among the molecular subtypes, but no clear relationship between high coexpression of PGR and AR and prognosis.


CONCLUSIONS
A favorable outcome was seen for patients whose tumors coexpressed PR and AR. Gene expression data suggested variable effects in the different molecular subtypes. These findings demonstrate a prognostic role for PR and AR in ovarian cancer and support that tumors should be stratified based on molecular as well as histological subtypes in future studies investigating the role of endocrine treatment in ovarian cancer.
Division of Oncology and Pathology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden. Electronic address: jenny-maria.jonsson@med.lu.se.
Jenny-Maria
JM
Jönsson
Division of Oncology and Pathology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden.
Nicolai Skovbjerg
NS
Arildsen
Division of Oncology and Pathology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden.
Susanne
S
Malander
Department of Surgical Pathology, Division of Laboratory Medicine, Skåne University Hospital, Lund, Sweden.
Anna
A
Måsbäck
Division of Oncology and Pathology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden; Regional Cancer Center South Sweden, Lund, Sweden.
Linda
L
Hartman
Division of Oncology and Pathology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden; Clinical Research Centre, Hvidovre University Hospital, Copenhagen University, Denmark.
Mef
M
Nilbert
Division of Oncology and Pathology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden; CREATE Health Strategic Center for Translational Cancer Research, Lund University, Lund, Sweden.
Ingrid
I
Hedenfalk