Predictive value of cell kinetics in endometrial adenocarcinoma

Flow cytometric DNA content and proliferative kinetic markers, S-phase frac tion (SPF) and thymidine labeling index (TLI), were evaluated in 68 patient s with endometrial carcinoma. A high rate of aneuploid tumors was detected (48.4%); median values of SPF and TLI were 6.4 and 6.2, respectively. No si gnificant relationship emerged between ploidy status and proliferative mark ers in respect to clinical and pathological variables. Aneuploid rumors had a higher recurrence rate than diploid tumors (21.8% vs 9.6%). but the diff erence was not statistically significant. According to the median value of both kinetic markers, the study population was divided into low and high-ri sk, where DFS was 100% and 71.4%, respectively (p = 0.05). Furthermore, hig h-TLI tumors (>6.2) had a significantly worse DFS (75.4%) than low-TLI (100 %) only among patients assigned to Stage I of the disease, regardless of ot her pathological variables. At multivariate analysis myometrial invasion re sulted as an independent and significant factor: Flow cytometric ploidy ana lysis was useless as a predictive biological parameter and did not add any further prognostic information to the pathologic variables. SPF and TLI val ues could indicate a subset of women with unexpected poor outcome in a grou p of patients generally considered at low-risk i.e. Stage I. If further inv estigation confirms these data, it could prove useful for therapeutic plann ing in endometrial cancer patients. Ar the present time, pathological and c linical fdctors are still the most reliable predictive parameters.