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DOI: 10.5146/tjpath.2022.01571
Evidence for Diverse Prognosis in High-Grade Serous Ovarian Carcinoma: Solid, Pseudoendometrioid, and Transitional-Like; So-Called “SET Morphology” and Progesterone Receptor Status
Halit UNER1, Metin DEMIR2, Dincer GOKSULUK3, Ayse KARS2, Meral UNER1, Alp USUBUTUN1
1Department of Pathology, Hacettepe University School of Medicine, ANKARA, TURKEY
2Department of Medical Oncology, Hacettepe University School of Medicine, ANKARA, TURKEY
3Department of Biostatistics, Hacettepe University School of Medicine, ANKARA, TURKEY
Keywords: Epithelial ovarian cancer, Prognosis, Morphology, BRCA1, Immunohistochemistry

Objective: High-grade serous ovarian carcinoma (HGSC) is one of the major tumors of the gynecological system with a poor survival rate and variable microscopic appearance. It was suggested that SET (solid, pseudo-endometrioid and transitional-like) morphology in ovarian HGSC is predictably associated with BRCA deficiencies. In this study, we investigated the microscopic patterns and some immunohistochemical markers predicting the prognosis of serous carcinoma.

Material and Method: We re-evaluated 305 HGSC ovarian resections morphologically and calculated the SET morphology percentages for each case. Morphological and immunohistochemical data correlated with the survival and post-treatment disease progression data.

Results: The median age at diagnosis was 57 years and the median follow-up period was 3.1 years. The median overall survival (OS) of ovarian carcinoma in SET-predominant tumors (n=60) was 81 months, while for tumors with SET non-dominant morphology (n=63) and non-SET morphology (n=182) it was 59.7 and 44.7 months, respectively.

Conclusion: Predominant (more than 50%) SET morphology was significantly associated with increased survival rates of HGSC. Immunohistochemically, p53, ERCC1, ER, and PR antibodies were applied and only PR antibody positivity was found to be associated with borderline statistical significance for increased survival rates. Our results suggest that SET morphology may be a potential predictive and prognostic marker in managing the treatment strategies of HGSC.

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