MULTIVARIATE SURVIVAL ANALYSIS OF CLINICOPATHOLOGICAL FEATURES IN SURGICAL STAGE-I ENDOMETRIOID CARCINOMA INCLUDING ANALYSIS OF HER-2 NEU EXPRESSION/

OBJECTIVE: We previously described vascular invasion-associated change s, defined as the presence of vascular invasion or perivascular lympho cytic infiltrates, as key prognostic indicators in stage I endometrioi d carcinoma. The current study was undertaken to examine the prognosti c value of HER2/neu expression in relation to other factors, including vascular invasion-associated changes, in surgical stage I endometrioi d carcinoma. STUDY DESIGN: Seventy-one patients with surgical stage I endometrioid carcinoma treated by hysterectomy and followed up were ra ndomly chosen for retrospective analysis of prognostic indicators incl uding standard clinicopathologic features, deoxyribonucleic acid ploid y, and HER-2/neu expression. The latter was examined by an objective c omputerized quantitative immunohistochemical system. RESULTS: By univa riate analysis many factors were found to correlate with outcome, incl uding age, tumor grade, depth of invasion, ploidy, HER-2/neu expressio n, and vascular invasion-associated changes. By multivariate analysis only vascular invasion-associated changes, aneuploidy, and HER-2/neu o verexpression were found to independently correlate with survival. Str atification of patients on the basis of these three features revealed survival rates of 100%, 92%, and 60% when none, one, and two or three features were present, respectively. CONCLUSION: This study suggests t hat HER-2/neu expression correlated with outcome independent of other factors in endometrial carcinoma and may aid in estimating prognosis. The prognostic value of HER-2/neu overexpression independent of vascul ar invasion suggests that this factor may operate by increasing the ab ility of tumor cells to grow at a distal site once vascular invasion o ccurs.