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Survivin Expression as a Prognostic Factor in Patients With Epithelial Ovarian Cancer or Primary Peritoneal Cancer Treated With Neoadjuvant Chemotherapy
  1. Agnieszka Gąsowska-Bodnar, PhD, MD*,
  2. Lubomir Bodnar, PhD, MD,
  3. Andrzej Dąbek, MD,
  4. Marzena Cichowicz, MSc,
  5. Małgorzata Jerzak, PhD, MD*,
  6. Szczepan Cierniak, MD,
  7. Wojciech Kozłowski, PhD, MD and
  8. Wlodzimierz Baranowski, PhD, MD*
  1. *Departments of Gynecology and Gynecologic Oncology,
  2. Oncology, and
  3. Pathology, Military Institute of Medicine, Warsaw, Poland.
  1. Address correspondence and reprint requests to Lubomir Bodnar, PhD, MD, Department of Oncology, Military Institute of Medicine, 04-141 Warsaw, 128 Szaserow Str, Poland. E-mail: lubo{at}esculap.p.


Background The aim of this study was to evaluate association of expression of survivin and p53 with the effects of neoadjuvant chemotherapy (NAC) in patients with advanced ovarian cancer (AOC).

Methods We retrospectively evaluated 60 consecutive patients with AOC (International Federation of Gynecology and Obstetrics stage IIIC-IV) treated with NAC. The expression of p53 and survivin was assessed immunohistochemically. The median of expression total score survivin equals 2 was adopted to dichotomize the group. The positive and negative expression of p53 was used to dichotomize the group.

Results The expression of survivin in tumor tissue taken before and after NAC was a significant difference in the percentage of stained nuclei (P = 0.0002), the intensity of staining (P = 0.0003), and total score (P = 0.0001). There was a significant difference in p53 expression in tumor tissue before and after NAC in the percentage of stained nuclei (P = 0.0424). Survivin expression, in contrast to p53 expression, was a prognostic factor in patients with AOC treated with NAC (P = 0.0484). The expression of survivin and p53 was not a predictive factor. Independent adverse predictor factors were as follows: lack of optimal interval debulking surgery and the lack of an objective response (the respective hazard ratio was 3.93 [95% confidence interval, 2.07–7.46; P < 0.0001] and 2.36 [95% confidence interval,1.25–4.47; P = 0.0080]). The suboptimal range of interval debulking surgery, resistance to platinum, and the lack of paclitaxel in the NAC were adverse prognostic factors (the respective hazard ratio was 2.61 [95% confidence interval, 1.17–5.83], 2.72 [95% confidence interval, 1.07–6.89], and 2.56 [95% confidence interval, 1.06–6.18]; P < 0.05]).

Conclusions High expression of survivin could be a prognostic factor in patients treated with NAC for AOC.

  • Ovarian cancer
  • Survivin
  • p53
  • Neoadjuvant chemotherapy
  • Interval debulking surgery

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  • The authors declare no conflicts of interest.