DNA INDEX BY IMAGE-ANALYSIS IN ADVANCED ENDOMETRIAL CARCINOMA

Background: Endometrial carcinoma is the most common gynecologic malig nancy in developed countries, affecting an estimated 140,000 women. Mo re than 32,000 women will be diagnosed with endometrial cancer this ye ar in the United States, and approximately 6,000 will die from this di sease. Methods: Twenty consecutive patients, surgically treated, with advanced endometrial cancer, were evaluated for their DNA index (DI), time to recurrence, peritoneal cytology, depth of invasion, lymphovasc ular space invasion, as well as FIGO stage, grade, and histology. DI w as determined using image analysis. Results: Ten of the 20 patients ha d recurrence of their disease within the 3-year observation period of the study. A DI of greater than or equal to 1.2 strongly predicted rec urrence of disease (P = 0.002). Increasing histologic grade and an inc reasing DI were related (P = 0.01). Conclusion: Independent of other p rognostic indicators, including lymphovascular space invasion, depth o f invasion, and histologic type, a tumor with a DI of greater than or equal to 1.2, had a significantly increased chance of recurring within the 3-year observation period. (C) 1996 Wiley-Liss, Inc.