Polymorphisms in the survivin promoter are associated with age of onset of ovarian cancer

Survivin has been identified as an apoptosis inhibitor and a key regulator of mitosis. A common polymorphism (-31G>C) at the survivin promoter has been extensively studied in various cancers and reported to influence survivin expression. We hypothesize that polymorphisms in the survivin promoter are associated with clinical outcomes of patients with ovarian cancer. In this study, we genotyped all of five common and independent (r(2) < 0.25 for all LD) survivin promoter polymorphisms (-1547A/G [rs3764383], -644C/T [rs8073903], -625C/G [rs8073069], -241C/T [rs17878467], and -31G/C [rs9904341]) in 168 patients with primary epithelial ovarian cancer, using the polymerase chain reaction-restriction fragment length polymorphism method. We found that -1547A/G and -31G/C were significantly associated with age of disease onset. Compared with patients with the -1547GG genotype, the -1547AA genotype showed a significantly younger age of disease onset (58.8 years vs. 70.1 years; P = 0.001); the -31CC genotype had a decrease, though not significant, in the age of disease onset, compared with patients with the -31GG genotype (57.1 years vs. 62.8 years; P = 0.058). The numbers of -1547A and -31C alleles were associated with a decrease in age of onset in an allele-dose response manner (P(trend) = 0.001 and 0.026, respectively). However, no association was found between survivin polymorphisms and patients' prognosis, except for -625C/G SNP in 37 patients with a persistent disease. The findings suggest that the promoter variants of survivin may have an effect on age of onset of ovarian cancer. Validation studies with larger sample sizes are warranted.