title: Mesothelium expression of vascular cell adhesion molecule-1 (VCAM-1) is associated with an unfavorable prognosis in epithelial ovarian cancer (EOC).
abstract: Mesothelium vascular cell adhesion molecule-1 (VCAM-1) expression in the metastatic epithelial ovarian cancer (EOC) microenvironment is induced by tumor and mediates tumor cell invasion. VCAM-1 imaging suggests expression during treatment is an indicator of platinum resistance. Here, we assess the potential prognostic significance of mesothelium VCAM-1 expression and prospectively evaluate whether soluble VCAM-1 (sVCAM-1) is a surrogate for mesothelium expression.
  
  
  
  A retrospective review of EOC patients was performed to evaluate outcomes with mesothelium VCAM-1 expression determined by immunohistochemistry of peritoneum or omentum specimens. A prospective cohort of EOC patients was identified and followed through primary treatment. Serum for sVCAM-1 evaluation, which was performed via enzyme-linked immunosorbent assay, was collected before surgery or neoadjuvant chemotherapy and at each treatment cycle. Peritoneal specimens were obtained during debulking to assess mesothelial VCAM-1 expression.
  
  
  
  A retrospective review identified 54 advanced-stage EOC patients. Patients expressing mesothelium VCAM-1 had shortened overall survival (44 vs 79 months, P = 0.035) and progression-free survival (18 vs 67 months, P = 0.010); the median time to platinum resistance was 36 months for VCAM-1-expressing patients and not yet determined for the VCAM-1-negative group. In our prospective observational cohort, 18 EOC patients completed primary treatment; 3 were negative for mesothelium VCAM-1 expression, and sVCAM-1 did not vary between groups.
  
  
  
  Mesothelium VCAM-1 expression is negatively associated with progression-free and overall survival in EOC. This is especially compelling in light of previous data suggesting that persistent VCAM-1 expression during treatment is an indicator of platinum resistance. Our pilot study had insufficient cases to determine whether sVCAM-1 would substitute for mesothelium expression. Cancer 2017;123:977-84. © 2016 American Cancer Society.
authors.affiliation: Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Scalici
authors.affiliation: Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia.
authors.forename: Sanja
authors.initials: S
authors.lastname: Arapovic
authors.affiliation: Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia.
authors.forename: Erin J
authors.initials: EJ
authors.lastname: Saks
authors.affiliation: Department of Pathology, University of Virginia, Charlottesville, Virginia.|Cancer Center, University of Virginia, Charlottesville, Virginia.
authors.forename: Kristen A
authors.initials: KA
authors.lastname: Atkins
authors.affiliation: Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia.|Cancer Center, University of Virginia, Charlottesville, Virginia.
authors.forename: Gina
authors.initials: G
authors.lastname: Petroni
authors.affiliation: Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia.|Cancer Center, University of Virginia, Charlottesville, Virginia.
authors.forename: Linda R
authors.initials: LR
authors.lastname: Duska
authors.affiliation: Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, Virginia.|Cancer Center, University of Virginia, Charlottesville, Virginia.
authors.forename: Jill K
authors.initials: JK
authors.lastname: Slack-Davis
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor; D000077216:Carcinoma, Ovarian Epithelial; D003131:Combined Modality Therapy; D004848:Epithelium / Q000378:metabolism* / Q000473:pathology; D005260:Female; D015870:Gene Expression; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality* / Q000628:therapy; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality* / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood / Q000235:genetics*
chemical_list: D014408:Biomarkers, Tumor; D019010:Vascular Cell Adhesion Molecule-1
keywords: epithelial ovarian cancer; mesothelium; metastasis; survival; tumor microenvironment; vascular cell adhesion molecule-1