Deoxyribonucleic acid ploidy in endometrial carcinoma: a reproducible and valid prognostic marker in a routine diagnostic setting.
ABSTRACT The objective of the study was to investigate the prognostic impact of deoxyribonucleic acid (DNA) ploidy in endometrial carcinoma in a routine diagnostic series as compared with a research series.
We studied a population-based series of 363 endometrial carcinomas prospectively collected, with long and complete follow-up. The prognostic value of DNA ploidy was investigated in a routine diagnostic series (n=262) and compared with the results from a previous research series (n=101).
The proportion of DNA aneuploid tumors was 21% in the research series and 25% in the routine diagnostic series (P=NS). In both series, DNA aneuploidy was significantly correlated to higher age at diagnosis, nonendometrioid subtype, and high histologic grade. Patients with DNA aneuploid tumors had significantly poorer survival, adjusted for established clinicopathologic prognostic factors.
DNA ploidy estimation in endometrial carcinoma adds independent prognostic information in a routine diagnostic setting.
Article: Endometrial cancer.[show abstract] [hide abstract]
ABSTRACT: Radical surgery including complete pelvic and para-arortic lymph node dissection (LND) is both the main therapeutic effort and the decisive staging procedure in patients with invasive endometrial cancer (EC) and should be performed in specialized institutions. Vaginal cuff brachytherapy holds little serious side effects and may be beneficial in preventing vaginal recurrences. External irradiation treatment no longer has a routine indication in primary therapy. The omission of retroperitoneal staging (LND) at primary surgery does not indicate adjuvant radiotherapy but rather second-effort surgery removing pelvic and para-aortic lymph-nodes. External radiotherapy should be reserved for fully staged patients with residual non-resectable tumor manifestation and/or nodal involvement in relation to the extent of tumor involvement and surgical intervention. Hormonal and cytotoxic therapy is experimental in the adjuvant setting. The first step in palliative systemic treatment should be the administration of endocrine therapy when the tumor expresses progesterone receptors and tumor manifestations are not acutely life-threatening. In other cases or when endocrine treatment fails chemotherapy may be considered, which is often limited due to its toxicity. Preferably, palliative hormonal and/or chemotherapy should be administered in controlled clinical trials.Onkologie 11/2003; 26(5):429-36. · 1.00 Impact Factor
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ABSTRACT: ab: To evaluate and correlate the expression of pathologic characteristics, flow cytometric DNA content analysis, and estrogen and progesterone receptor levels with survival in patients with surgical Stage I endometrial carcinoma.: Hospital tumor registry records were surveyed, and this identified 232 patients diagnosed with endometrial adenocarcinoma between July 1, 1989, and December 30, 1993. DNA content analysis was performed on either paraffin-embedded or fresh tissue samples. Survival was calculated from the date of diagnosis by the Kaplan-Meier method. Postoperative irradiation (whole pelvis external beam therapy and low dose rate vaginal cuff brachytherapy) was delivered to patients felt to be at high risk for failure.: One hundred seventy-one patients had Stage I tumors and were available for analysis. Patients with Stage IC tumors had a statistically significant lower survival rate compared to patients with Stages IA or IB (p = 0.03 and p < 0.01, respectively). Patients with DNA content diploid tumors had a slightly increased (but nonsignificantly so) survival compared to patients with non-DNA content diploid tumors (p = 0.12). Logistic regression analysis failed to identify an independent prognostic factor that could predict for disease specific survival in patients with Stage I cancers.: Logistic regression analysis did not identify a single independent prognostic factor in patients with Stage I tumors. Pathologic characteristics reported to predict survival advantage correlated with pathologic stage. Additional translational research is needed to identify molecular characteristics of tumors that may indicate more aggressive treatment for patients at high risk for recurrence.International Journal of Radiation OncologyBiologyPhysics 08/1996; · 4.52 Impact Factor
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ABSTRACT: In a retrospective analysis of 106 cases of endometrial carcinoma stages I-IV (FIGO), the prognostic value of DNA ploidy and nuclear morphometry of tumor cells was evaluated and compared with that of conventional clinical and histopathologic parameters. Paraffin-embedded tumor tissue from the original curettage specimens was used. A flow cytometric technique was employed to distinguish diploid from aneuploid tumors. It was not possible to estimate S-phase rates by this method. Eight different nucleus-related morphometric parameters were computed from representative tumor regions on the original slides. All histologic specimens were reviewed by on the pathologist and graded according to FIGO; nuclear grade was determined separately. Tumor stage, depth of myometrial infiltration, and nuclear grade were the most important prognostic factors with regard to tumor-related survival. DNA ploidy and nuclear morphometry did not add significant prognostic information that could be used to distinguish high-risk and low-risk populations with endometrial carcinomas. The simple nuclear grading system should be further evaluated in prospective studies and compared with DNA analysis and nuclear morphometry performed on fresh-frozen tissue.Gynecologic Oncology 08/1990; 38(1):22-7. · 3.93 Impact Factor