THE PROGNOSTIC INFORMATION OF DNA-PLOIDY AND S-PHASE FRACTION MAY VARY WITH HISTOLOGIC GRADE IN ENDOMETRIAL CARCINOMA

DNA ploidy and S-phase fraction (SPF) were determined by flow cytometr y on paraffin-embedded tumor material from 243 patients treated during 1980-1985. Patients with well differentiated and moderately different iated tumors without solid areas (n = 351) formed a low-risk group (co rrected 5-year survival 90%). Twenty-four patients, dead of disease wi thin 5 years, were compared with 52 survivors. The estimated death ris k was higher for those with SPF greater than or equal to 8.0% compared with those with SPF < 8.0% (odds ratio = 18.2; p < 0.001). SPF was th e only independent prognostic factor in a multivariate analysis also i ncluding age, clinical stage and grade of differentiation. Patients wi th moderately differentiated tumors with solid areas or poorly differe ntiated tumors (n = 208) were regarded as a high-risk group. There was a difference in survival according to ploidy; the corrected 5-year su rvival was 75% for 106 patients with diploid tumors compared with 44% for those with non-diploid tumors (p < 0.0001). In a multivariate anal ysis DNA ploidy, age and clinical stage were independent prognostic fa ctors, whereas SPF was no longer significant. Thus, DNA ploidy and SPF have different prognostic values depending on histological grade of e ndometrial carcinoma.