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The Clinicopathological and Prognostic Values of Chemotherapy Response Score in Tubo-Ovarian High-Grade Serous Carcinoma

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Indian Journal of Gynecologic Oncology Aims and scope Submit manuscript

Abstract

Purpose

Tubo-ovarian high-grade serous carcinoma is one of the aggressive ovarian tumors. Neoadjuvant chemotherapy has been used in managing the affected patients. The chemotherapy response score (CRS) system has been introduced to evaluate the patient’s response to neoadjuvant chemotherapy and their prognosis. The current study aimed to investigate the prognostic and clinicopathological significance of the CRS system in patients with tubo-ovarian high-grade serous carcinoma.

Methods

A total of 39 patients with tubo-ovarian high-grade serous carcinoma were included in the current study. We retrospectively investigated the progression-free survival (PFS), overall survival (OS), and their clinicopathological and surgical parameters. We also studied the Ki67 protein expression of included patients using immunohistochemistry (IHC). Besides, we investigated the significance of Ki67 expression in tubo-ovarian high-grade serous carcinoma development using the GSE73064 and GSE126308 datasets.

Results

Ki67 expression was not alerted in ascites, metastatic, and primary tubo-ovarian high-grade serous carcinoma. Also, Ki67 expression was not changed in the early tubo-ovarian high-grade serous carcinoma compared to late tubo-ovarian high-grade serous carcinoma. We showed that Ki67 protein expression was elevated in CRS1 patients with tubo-ovarian high-grade serous carcinoma compared to CRS3 patients. The bleeding amount and operation time were substantially lower in CRS3 patients compared to CRS1 patients, and there was a strong positive association between CRS3 and optimal resection. Furthermore, CRS3 patients had substantially improved PFS compared to CRS1 patients.

Conclusion

This study has highlighted the valuable role of the CRS system in determining the PFS and some clinicopathological features of tubo-ovarian high-grade serous carcinoma patients.

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References

  1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7–33.

    Article  PubMed  Google Scholar 

  2. Kurman RJ, Shih I-M. The dualistic model of ovarian carcinogenesis: revisited, revised, and expanded. Am J Pathol. 2016;186(4):733–47.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Singh N, McCluggage WG, Gilks CB. High-grade serous carcinoma of tubo-ovarian origin: recent developments. Histopathology. 2017;71(3):339–56.

    Article  PubMed  Google Scholar 

  4. Vergote I, Tropé CG, Amant F, Kristensen GB, Ehlen T, Johnson N, et al. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N Engl J Med. 2010;363(10):943–53.

    Article  CAS  PubMed  Google Scholar 

  5. Kehoe S, Hook J, Nankivell M, Jayson GC, Kitchener H, Lopes T, et al. Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. The Lancet. 2015;386(9990):249–57.

    Article  Google Scholar 

  6. Böhm S, Faruqi A, Said I, Lockley M, Brockbank E, Jeyarajah A, et al. Chemotherapy response score: development and validation of a system to quantify histopathologic response to neoadjuvant chemotherapy in tubo-ovarian high-grade serous carcinoma. J Clin Oncol. 2015;33(22):2457–63.

    Article  PubMed  Google Scholar 

  7. McCluggage WG, Judge MJ, Clarke BA, Davidson B, Gilks CB, Hollema H, et al. Data set for reporting of ovary, fallopian tube and primary peritoneal carcinoma: recommendations from the international collaboration on cancer reporting (ICCR). Mod Pathol. 2015;28(8):1101–22.

    Article  PubMed  Google Scholar 

  8. Coghlan E, Meniawy TM, Munro A, Bulsara M, Stewart CJ, Tan A, et al. Prognostic role of histological tumor regression in patients receiving neoadjuvant chemotherapy for high-grade serous tubo-ovarian carcinoma. Int J Gynecol Cancer. 2017;27(4):708–13.

    Article  PubMed  Google Scholar 

  9. Lee JY, Chung YS, Na K, Kim HM, Park CK, Nam EJ, et al. External validation of chemotherapy response score system for histopathological assessment of tumor regression after neoadjuvant chemotherapy in tubo-ovarian high-grade serous carcinoma. J Gynecol Oncol. 2017;28(6): e73.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011;144(5):646–74.

    Article  CAS  PubMed  Google Scholar 

  11. Mrouj K, Andrés-Sánchez N, Dubra G, Singh P, Sobecki M, Chahar D, et al. Ki-67 regulates global gene expression and promotes sequential stages of carcinogenesis. Proc Natl Acad Sci. 2021;118(10): e2026507118.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Li LT, Jiang G, Chen Q, Zheng JN. Ki67 is a promising molecular target in the diagnosis of cancer (review). Mol Med Rep. 2015;11(3):1566–72.

    Article  CAS  PubMed  Google Scholar 

  13. Mahadevappa A, Krishna SM, Vimala MG. Diagnostic and prognostic significance of Ki-67 immunohistochemical expression in surface epithelial ovarian carcinoma. J Clin Diagn Res. 2017;11(2):Ec 08-ec12.

    CAS  Google Scholar 

  14. Ditzel HM, Strickland KC, Meserve EE, Stover E, Konstantinopoulos PA, Matulonis UA, et al. Assessment of a chemotherapy response score (CRS) system for tubo-ovarian high-grade serous carcinoma (HGSC). Int J Gynecol Pathol. 2019;38(3):230–40.

    Article  PubMed  Google Scholar 

  15. Labidi-Galy SI, Papp E, Hallberg D, Niknafs N, Adleff V, Noe M, et al. High grade serous ovarian carcinomas originate in the fallopian tube. Nat Commun. 2017;8(1):1093.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Chui MH, MomeniBoroujeni A, Mandelker D, Ladanyi M, Soslow RA. Characterization of TP53-wildtype tubo-ovarian high-grade serous carcinomas: rare exceptions to the binary classification of ovarian serous carcinoma. Mod Pathol. 2021;34(2):490–501.

    Article  CAS  PubMed  Google Scholar 

  17. Singh P, Kaushal V, Rai B, Rajwanshi A, Gupta N, Dey P, et al. The chemotherapy response score is a useful histological predictor of prognosis in high-grade serous carcinoma. Histopathology. 2018;72(4):619–25.

    Article  PubMed  Google Scholar 

  18. Coghlan E, Meniawy TM, Munro A, Bulsara M, Stewart CJ, Tan A, et al. Prognostic role of histological tumor regression in patients receiving neoadjuvant chemotherapy for high-grade serous tubo-ovarian carcinoma. International Journal of Gynecologic Cancer. 2017;27(4).

  19. Santoro A, Angelico G, Piermattei A, Inzani F, Valente M, Arciuolo D, et al. Pathological chemotherapy response score in patients affected by high grade serous ovarian carcinoma: the prognostic role of omental and ovarian residual disease. Front Oncol. 2019;9:778.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Ali MA, Durrani N, Parveen K, Ahmad Z, Meenai FJ. Prognostic role of crs in high grade serous ovarian tumour patients receiving neoadjuvant chemotherapy in a tertiary care hospital of central india. Journal of Clinical & Diagnostic Research. 2022;16(5).

  21. Lawson BC, Yang RK, Euscher ED, Ramalingam P, Malpica A. TP53 variant allele frequency correlates with the chemotherapy response score in ovarian/fallopian tube/peritoneal high-grade serous carcinoma. Hum Pathol. 2021;115:76–83.

    Article  CAS  PubMed  Google Scholar 

  22. Amadori D, Volpi A, Maltoni R, Nanni O, Amaducci L, Amadori A, et al. Cell proliferation as a predictor of response to chemotherapy in metastatic breast cancer: a prospective study. Breast Cancer Res Treat. 1997;43(1):7–14.

    Article  CAS  PubMed  Google Scholar 

  23. Rödel F, Zhou S, Győrffy B, Raab M, Sanhaji M, Mandal R, et al. The prognostic relevance of the proliferation markers Ki-67 and Plk1 in early-stage ovarian cancer patients with serous, low-grade carcinoma based on mRNA and protein expression. Front Oncol. 2020;10: 558932.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Zheng JN, Sun YF, Pei DS, Liu JJ, Ma TX, Han RF, et al. Treatment with vector-expressed small hairpin RNAs against Ki67 RNA-induced cell growth inhibition and apoptosis in human renal carcinoma cells. Acta Biochim Biophys Sin. 2006;38(4):254–61.

    Article  CAS  PubMed  Google Scholar 

  25. Hou Y-Y, Cao W-W, Li L, Li S-P, Liu T, Wan H-Y, et al. MicroRNA-519d targets MKi67 and suppresses cell growth in the hepatocellular carcinoma cell line QGY-7703. Cancer Lett. 2011;307(2):182–90.

    Article  CAS  PubMed  Google Scholar 

  26. Kaya R, Takanashi H, Nakajima A, Saito R, Yamaguchi N, Morimoto K, et al. Prognostic significance of Ki67 during neoadjuvant chemotherapy in primary unresectable ovarian cancer. J Obstet Gynaecol Res. 2021;47(11):3979–89.

    Article  CAS  PubMed  Google Scholar 

  27. Liu P, Sun YL, Du J, Hou XS, Meng H. CD105/Ki67 coexpression correlates with tumor progression and poor prognosis in epithelial ovarian cancer. Int J Gynecol Cancer. 2012;22(4):586–92.

    Article  PubMed  Google Scholar 

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Acknowledgements

We appreciate all of the healthcare providers of Alzahra Hospital, a teaching and tertiary referral hospital affiliated with Tabriz University of Medical Sciences, Tabriz, Iran. The authors acknowledge the “Clinical Research Development Unit, Al-Zahra Hospital,” Tabriz University of Medical Sciences.

Funding

This work was supported by Tabriz University of Medical Sciences, Tabriz, Iran (Grant Number: 68828). P.M.G has received research support from Tabriz University of Medical Sciences, Tabriz, Iran.

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Authors and Affiliations

  1. Fellowship in Gynecologic Oncology, Women’s Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

    Roghaiyeh Derogar

  2. Faculty of Medicine, Islamic Azad University, Tabriz Branch, Tabriz, Iran

    Amirreza Mirzaei

  3. Women’s Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

    Manizheh Sayyah-Melli, Mehri Jafari-Shobeiri, Vahideh Rahmani, Maryam Vaezi, Ali Dastranj Tabrizi & Parvin Mostafa-Gharabaghi

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  1. Roghaiyeh Derogar
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Contributions

RD was involved in the investigation, methodology, data collection and analysis, writing—original draft, and writing—review and editing. AM contributed to the conceptualization, methodology, writing—original draft, and writing—review and editing. MSM assisted in the conceptualization and writing—review and editing. MJS was involved in the conceptualization, methodology, and writing—review and editing. VR contributed to the conceptualization, methodology, and writing—review and editing. MV assisted in the conceptualization, methodology, and writing—review and editing. ADT was involvd in the conceptualization, data analysis, and writing—review and editing. PMG contributed to the conceptualization, methodology, funding acquisition, supervision, writing—original draft, and writing—review and editing.

Corresponding authors

Correspondence to Ali Dastranj Tabrizi or Parvin Mostafa-Gharabaghi.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical Approval

This study was performed in line with the principles of the Declaration of Helsinki. This study was approved by the Ethics Committee of Tabriz University of Medical Sciences (IR.TBZMED.REC.1401.398).

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Derogar, R., Mirzaei, A., Sayyah-Melli, M. et al. The Clinicopathological and Prognostic Values of Chemotherapy Response Score in Tubo-Ovarian High-Grade Serous Carcinoma. Indian J Gynecol Oncolog 22, 58 (2024). https://doi.org/10.1007/s40944-024-00812-1

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