Development and validation of a DNA methylation signature to predict the progression-free survival in patients with advanced-stage ovarian cancer

Abstract Background: Ovarian cancer (OC) is a disease characterized by late-stage presentation and poor prognosis. Our aim was to identify a DNA methylation signature for predicting progression-free survival (PFS) of patients with advanced-stage OC.Methods: A bioinformatics analysis was performed to identify methylation sites that are relevant to PFS and develop a DNA methylation signature. A total of 501 patients with advanced-stage OC who were identified from the Cancer Genome Atlas (TCGA) were enrolled as a training cohort, and 108 patients with advanced-stage OC from GSE65820 were used as a validation cohort.Results: A DNA methylation signature was constructed on the basis of five methylation sites. We found that patients with OC in the training and validation cohorts could be stratified, based on the DNA methylation signature, into high- and low-risk groups with distinct prognosis. Different cancer-related pathways were enriched between these two groups. Finally, a nomogram that integrated the methylation signature risk score and clinical stage was established, and the nomogram performed well.Conclusions: The DNA methylation signature provides a promising prognostic biomarker for patients with advanced-stage OC and may help to optimize clinical management.