Prognostic relevance of carbonic anhydrase-IX in high-risk, early-stage cervical cancer: a Gynecologic Oncology Group study.

Abstract

OBJECTIVES:

This study aimed to determine whether carbonic anhydrase-IX (CA-IX) was associated with progression-free survival (PFS) and overall survival (OS) in women with high-risk, early-stage cervical cancer treated with adjuvant pelvic radiotherapy with or without radiosensitizing chemotherapy.

METHODS:

CA-IX expression was detected using an immunohistochemistry assay and categorized as low when <or=80% of tumor cells exhibited CA-IX staining and high when >80% tumor cells display CA-IX staining. Associations between CA-IX expression and clinical characteristics, angiogenesis marker expression, and clinical outcome were evaluated.

RESULTS:

High CA-IX expression was observed in 35/166 (21.1%) of cases. CA-IX expression was not associated with age, race, stage, cell type, grade, positive margins, parametrial extensions, positive lymph nodes, or lymphovascular space invasion but was associated with tumor size categorized as <2 , 2-2.9 , or >or=3 cm (high expression: 4.7% vs. 23.2% vs. 32.5%, P=0.003) and cervical invasion confined to the inner two-thirds compared with the outer third of the cervix (high expression: 6.1% vs. 23.7%, P=0.028). CA-IX expression was not associated with immunohistochemical expression of p53, CD31, CD105, thrombospondin-1, or vascular endothelial growth factor-A. Women with high versus low CA-IX expression had similar PFS (P=0.053) and significantly worse OS (P=0.044). After adjusting for prognostic clinical covariates, high CA-IX expression was an independent prognostic factor for PFS (hazard ratio [HR]=2.12; 95% confidence interval [CI]=1.13-3.95; P=0.019) and OS (HR=2.41; 95% CI=1.24-4.68; P=0.009).

CONCLUSIONS:

Tumor hypoxia measured by immunohistochemical expression of CA-IX is an independent prognostic factor for both PFS and OS in high-risk, early-stage cervical cancer.

• Authors: Shu-Yuan Liao, Kathleen M Darcy, Leslie M Randall, Chunqiao Tian, Bradley J Monk, Robert A Burger, John P Fruehauf, William A Peters, Richard J Stock, Eric J Stanbridge
• Journal: Gynecologic oncology (Gynecol Oncol) Vol. 116 Issue 3 Pg. 452-8 (Mar 2010) ISSN: 1095-6859 [Electronic] United States
• PMID: 19913895 (Publication Type: Clinical Trial, Phase III, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural)

Chemical References

• Antigens, Neoplasm
• CA9 protein, human
• Carbonic Anhydrase IX
• Carbonic Anhydrases

Topics

• Adult
• Aged
• Antigens, Neoplasm (biosynthesis)
• Carbonic Anhydrase IX
• Carbonic Anhydrases (biosynthesis)
• Disease-Free Survival
• Female
• Humans
• Immunohistochemistry
• Middle Aged
• Neoplasm Staging
• Proportional Hazards Models
• Risk Factors
• Survival Rate
• Uterine Cervical Neoplasms (enzymology, pathology, therapy)