THE PROGNOSTIC-SIGNIFICANCE OF SURGERY, TUMOR SIZE, MALIGNANCY GRADE,MENOPAUSAL STATUS, AND DNA-PLOIDY IN ENDOMETRIAL STROMAL SARCOMA

To evaluate the prognostic significance of DNA ploidy in endometrial s tromal sarcoma, the traditional clinical and histopathological prognos tic variables and DNA ploidy in 48 patients with histologically verifi ed endometrial stromal sarcoma were analyzed. Evaluable how cytometric DNA histograms from paraffin-embedded tissue from the tumor were obta ined in 47 patients. In univariate analysis, malignancy grade (P < 0.0 01), cellular atypia (P < 0.001), tumor diameter (P = 0.001), and mito tic count (P = 0.002) mere highly significant. Also menopausal status (P = 0.011), FIGO stage (P = 0.035), and free resection margins at pri mary surgery (P = 0.026) obtained significance, while vessel invasion and age did not. DNA ploidy was not significant. In Cox multivariate a nalysis, free resection margins at primary surgery were found to be th e most important prognostic factor (P < 0.001), followed by malignancy grade (P = 0.002), tumor diameter (P = 0.019), and menopausal status (P = 0.019). DNA ploidy did not obtain significance. Free resection ma rgins at primary surgery, malignancy grade, tumor diameter, and menopa usal status are important prognostic factors in endometrial stromal sa rcoma. (C) 1996 Academic Press, Inc.