title: Peritoneal cytology and preoperative serum CA 125 level are important prognostic indicators of overall survival in advanced endometrial cancer.
abstract: BACKGROUND
  The current study aimed to evaluate flow cytometry findings, peritoneal cytology and preoperative CA 125 level as prognostic factors of endometrial carcinoma.
  
  
  METHODS
  A retrospective study of 44 patients with FIGO stage II-IV endometrial carcinoma who underwent abdominal hysterectomy, bilateral salpingo-oophorectomy and, all except three, pelvic lymph node dissection. At operation, a peritoneal washing sample was taken for cytological examination. Flow cytometry was performed on fresh primary tumor samples. Blood samples were obtained within 2 weeks before surgery. The median follow-up time was 54 months.
  
  
  RESULTS
  In univariate analysis, DNA ploidy, S-phase fraction, serum CA 125 level and peritoneal cytological findings correlated significantly with survival. In multivariate analysis, peritoneal cytology (benign versus malignant), grade (1 + 2 versus 3) and preoperative serum CA 125 concentration (< or = 25 U/ml versus > 25 U/ml) remained significant independent predictors of overall survival. DNA ploidy and S-phase fraction had a strong correlation with peritoneal cytology. Malignant cytological findings were more frequent in cases with DNA aneuploidy and S-phase fraction higher than 8%.
  
  
  CONCLUSIONS
  In addition to histological grade, peritoneal cytology and preoperative serum CA 125 level were also important independent prognostic indicators of outcome.
authors.affiliation: Department of Obstetrics and Gynecology, University of Oulu, Finland. msantala@cc.oulu.fi
authors.forename: Markku
authors.initials: M
authors.lastname: Santala
authors.forename: Anne
authors.initials: A
authors.lastname: Talvensaari-Mattila
authors.forename: Antti
authors.initials: A
authors.lastname: Kauppila
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018394:CA-125 Antigen / Q000097:blood*; D016889:Endometrial Neoplasms / Q000097:blood* / Q000473:pathology*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010529:Peritoneal Cavity / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D018394:CA-125 Antigen