PROGNOSTIC VALUE OF DNA-PLOIDY AND S-PHASE FRACTION IN ENDOMETRIAL CANCER STAGE-I AND STAGE-II - A PROSPECTIVE 5-YEAR SURVIVAL STUDY

Knowledge of reliable prognostic factors is essential in cancer treatm ent. Especially when intensified treatment is to be considered to impr ove the overall result, it is desirable to identify well-defined high- risk groups. In a prospective study DNA ploidy and S-phase fraction we re measured in 88 patients with endometrial cancer stage I and II. Fre sh tumor samples were analyzed using flow cytometry prior to treatment . Diploid tumors represented 84% of the cases, and aneuploid represent ed 16%. The mean S-phase fraction in diploid tumors was 10%, as compar ed with 22% in aneuploid tumors. The follow-up time was 5 years in all cases. The survival rate for patients with diploid tumors was 92% and for aneuploid tumors 36%. In the surviving patients, the mean S-phase fraction was 10.4%, a significant difference from 19.9% in the nonsur viving patients (P < 0.001). The highest mortality was found when aneu ploidy was combined with an S-phase fraction over 20%, with only 11% s urvival for 5 years. In diploid tumors with an S-phase fraction below 20%, the survival rate was 92%. In a stepwise regression analysis, S-p hase fraction was found to be of the most important prognostic value, followed by myometrial invasion and stage of the tumor and ploidy. Gra de was not found to be of any important significance. (C) 1994 Academi c Press, Inc.