Objective: The excision repair cross-complementation group 1 (ERCC1) expression is a predictor of survival after surgical treatment for several malignancies. Its overexpression has been reported as a marker of platinum resistance in lung cancer. However, the relevance of ERCC1 expression in ovarian cancer (OC) is the subject of controversy, both as a predictive parameter for platinum resistance and because of its association with poor prognosis. Therefore, we performed a retrospective study investigating ERCC1 expression and its correlation with patients' survival in OC.
Methods: We analyzed the ERCC1 protein expression using four different ERCC1 antibodies (clone 8F1) with different staining protocols. Immunohistochemistry was performed on multi-tissue microarrays (77 patients with primary serous ovarian cancer treated between 1999 and 2004; median age at diagnosis 67 years; range 32 to 88 years; 90% FIGO III+IV). In all cases cytoreductive surgery was followed by platinum-based chemotherapy.
Results: The Kaplan-Meier analysis revealed that the survival of patients with ERCC1-negative OCs (n=45; 62%) was significantly better (median survival 50.0 months) compared with the ERCC1-positive group (n=32; 38%; 20 months; p=0.004). Furthermore, ERCC1 expression was of prognostic relevance (p=0.002) in the case of negative expression in patients with residual tumor, where a higher survival rate was observed (median survival 30 months compared to 7.8 months in the ERCC1-positive group).
Conclusions: ERCC1 protein overexpression may act as a prognostic marker for poor survival of high-grade OC even in patients operated with residual disease.
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