title: Prognostic importance of DNA flow cytometric variables in rhabdomyosarcomas.
abstract: OBJECTIVE
  To determine whether DNA ploidy patterns and S phase fraction offer prognostic information in patients with rhabdomyosarcoma (RMS).
  
  
  METHODS
  DNA flow cytometry was performed on formalin fixed, paraffin wax embedded samples from primary tumours, and metastatic deposits or recurrences in 70 patients. DNA histogram analysis was done using a semi-automated cell cycle analysis program.
  
  
  RESULTS
  Of the 70 primary tumours, 23 were DNA diploid, 32 DNA aneuploid, eight DNA multiploid, and seven DNA tetraploid. The prognosis for DNA aneuploid patterns was favourable, intermediate within the group of DNA tetraploid tumours and poor among patients with DNA diploid and DNA multiploid tumours (p = 0.009). In multivariate analysis (Cox regression model) DNA ploidy was an important independent prognostic factor, along with TNM stage, localisation, and histopathological classification. Ten out of 32 patients with a high S phase fraction (> 15%) with primary RMS achieved long term survival in contrast to 20 out of 29 patients with a low S phase fraction (< or = 15%) (p = 0.008). In 24 cases the DNA ploidy of cases of relapse was analysed. Of the 15 cases, in which stem line changes had occurred, 13 died of disease. No stem line changes were noted in nine cases and in this group four patients died of disease (p = 0.02).
  
  
  CONCLUSIONS
  Assessment of DNA ploidy and S phase fraction in primary RMS and evaluation of stem line changes in cases of relapse are important variables in predicting prognosis.
authors.affiliation: Department of Pathology, Free University of Amsterdam.
authors.forename: L C
authors.initials: LC
authors.lastname: Wijnaendts
authors.forename: J C
authors.initials: JC
authors.lastname: van der Linden
authors.forename: P
authors.initials: P
authors.lastname: van Diest
authors.forename: A J
authors.initials: AJ
authors.lastname: van Unnik
authors.forename: J F
authors.initials: JF
authors.lastname: Delemarre
authors.forename: P A
authors.initials: PA
authors.lastname: Voûte
authors.forename: C J
authors.initials: CJ
authors.lastname: Meijer
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004273:DNA, Neoplasm / Q000032:analysis*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007223:Infant; D008297:Male; D011003:Ploidies; D011379:Prognosis; D012044:Regression Analysis; D012208:Rhabdomyosarcoma / Q000235:genetics* / Q000473:pathology; D016196:S Phase; D013997:Time Factors
chemical_list: D004273:DNA, Neoplasm