Glucocorticosteroid receptors in ovarian carcinomas

The use of glucocorticoids (GCs) in oncology, including in the treatment of ovarian carcinomas, is controversial. In vitro experiments suggest that GCs negatively influence the response to chemotherapy, but the few available clinical data show only benefits. Glucocorticoid action is mediated via glucocorticoid receptors (GRs). This study aims to define any clinical implications of GR expression in ovarian cancer to further the debate. Archived tissue samples from patients with histologically confirmed ovarian cancer were analyzed for GR expression and evaluated by immunohistochemistry and immunoreactive score. The results were related to the patients' overall survival. Kaplan-Meier survival and residual survival analyses gave no evidence that GR expression had any prognostic value in the 85 cases studied. No evidence of poorer survival was found in a small subset of GR-positive patients who received GC treatment. Glucocorticoid receptor expression had no prognostic impact in our study. However, GC (cortisol) is being produced continuously by the body, which may have stimulated GR-positive ovarian cancer cells. Our finding does not exclude the possibility that long-term GC treatment has adverse effects, and it should also be emphasized that treatment duration, dosage and dosing regimens, as well as the choice of an appropriate GC and the mode of application, determine the risks and benefits. Our study showed no evidence against using GC for antiemetic prophylaxis in ovarian carcinomas.