Allison M Puechl1, James Edwards2, Anuj Suri3, John Nakayama4, Sarah Bean5, Paola Gehrig6, Erin Saks7, Linda Duska8, Gloria Broadwater9, Jessie Ehrisman9, Neil Horowitz10, Angeles Alvarez Secord9. 1. Division of Gynecologic Oncology, Duke Cancer Institute, Durham, NC, United States of America. Electronic address: allison.puechl@duke.edu. 2. WakeMed Health and Hospitals, Raleigh, NC, United States of America. 3. Houston Methodist Gynecologic Oncology Associates, Houston, TX, United States of America. 4. Univerity Hospitals, Cleveland, OH, United States of America. 5. Duke University, Department of Pathology, Durham, NC, United States of America. 6. University of North Carolina at Chapel Hill Division of Gynecologic Oncology, Chapel Hill, NC, United States of America. 7. Carilion Clinic, Roanoke, VA, United States of America. 8. University of Virginia, Division of Gynecologic Oncology, United States of America. 9. Division of Gynecologic Oncology, Duke Cancer Institute, Durham, NC, United States of America. 10. Brigham and Women's Hospital, Division of Gynecologic Oncology, United States of America.
Abstract
BACKGROUND: Granulosa cell tumors (GCT) variably express estrogen receptors (ER) and progesterone receptors (PR). The goal of this study is to evaluate the relationship between ER and PR expression patterns and clinical outcomes in women with GCT. METHODS: A multicenter, retrospective analysis was performed of all cases of GCT diagnosed between 1989 and 2012. Immunohistochemical staining for ER and PR was performed on formalin-fixed paraffin embedded (FFPE) tumor tissue and interpreted using a semiquantitative scoring system that incorporated tumor cell staining proportion and intensity. Demographics, disease status, and survival information were collected. Associations between ER and PR staining scores and recurrence-free and overall survival were assessed using univariate Cox proportional hazards models. RESULTS: FFPE tumor blocks were available for 149/186 GCT patients. The majority of the women had clinical stage I disease (76%). ER and PR expression was present in 52% and 98% of subjects, respectively. The median composite scores of ER and PR staining were 1 (range 0-8) and 9 (range 0-15), respectively. In univariate analysis, PR composite score >9 was strongly associated with decreased recurrence-free survival (HR = 2.9, 95% CI = 1.5-5.5) and decreased overall survival (HR = 3.7, CI 1.3-10.2). ER composite score was not a significant predictor of recurrence-free survival or overall survival (p = 0.7, HR = 1.1, 95% CI 0.6-2.0 and p = 0.06, HR = 1.1, 95% CI 0.4-2.9, respectively). CONCLUSIONS: Our results reveal that high PR composite score (≥9) was associated with both decreased recurrence-free and overall survival in patients with GCT while ER expression was not associated with survival outcomes.
BACKGROUND:Granulosa cell tumors (GCT) variably express estrogen receptors (ER) and progesterone receptors (PR). The goal of this study is to evaluate the relationship between ER and PR expression patterns and clinical outcomes in women with GCT. METHODS: A multicenter, retrospective analysis was performed of all cases of GCT diagnosed between 1989 and 2012. Immunohistochemical staining for ER and PR was performed on formalin-fixed paraffin embedded (FFPE) tumor tissue and interpreted using a semiquantitative scoring system that incorporated tumor cell staining proportion and intensity. Demographics, disease status, and survival information were collected. Associations between ER and PR staining scores and recurrence-free and overall survival were assessed using univariate Cox proportional hazards models. RESULTS: FFPE tumor blocks were available for 149/186 GCT patients. The majority of the women had clinical stage I disease (76%). ER and PR expression was present in 52% and 98% of subjects, respectively. The median composite scores of ER and PR staining were 1 (range 0-8) and 9 (range 0-15), respectively. In univariate analysis, PR composite score >9 was strongly associated with decreased recurrence-free survival (HR = 2.9, 95% CI = 1.5-5.5) and decreased overall survival (HR = 3.7, CI 1.3-10.2). ER composite score was not a significant predictor of recurrence-free survival or overall survival (p = 0.7, HR = 1.1, 95% CI 0.6-2.0 and p = 0.06, HR = 1.1, 95% CI 0.4-2.9, respectively). CONCLUSIONS: Our results reveal that high PR composite score (≥9) was associated with both decreased recurrence-free and overall survival in patients with GCT while ER expression was not associated with survival outcomes.
Authors: Florian Viehweger; Lisa-Marie Tinger; David Dum; Natalia Gorbokon; Anne Menz; Ria Uhlig; Franziska Büscheck; Andreas M Luebke; Claudia Hube-Magg; Andrea Hinsch; Doris Höflmayer; Christoph Fraune; Patrick Lebok; Sören Weidemann; Maximilian Lennartz; Frank Jacobsen; Till S Clauditz; Rainer Krech; Till Krech; Andreas H Marx; Ronald Simon; Eike Burandt; Stefan Steurer; Guido Sauter; Sarah Minner; Christian Bernreuther Journal: Anal Cell Pathol (Amst) Date: 2022-08-08 Impact factor: 4.133