title: Prognostic significance of DNA ploidy in stage I endometrial cancer.
abstract: OBJECTIVE
  To improve the outcome for patients with endometrial cancer, a more accurate prognostic assessment is needed. The current study was undertaken to determine the role of flow cytometric DNA ploidy as an independent prognostic factor in patients with stage I endometrial cancer and to verify if ploidy is able to identify high-risk cases among the apparent 'low-risk' patients, defined as stage (IA), grade (1 or 2), and histologic type (endometrioid).
  
  
  METHODS
  This was a retrospective study. DNA ploidy was evaluated from tumor samples in 217 patients with stage I endometrial cancer who underwent definitive surgery as the first treatment between 2003 and 2009. Ploidy and other classic parameters were analyzed in relation to the length of recurrence-free survival.
  
  
  RESULTS
  Among the 217 evaluated patients, 184 (84.8%) had diploid tumors and 33 (15.2%) had aneuploid tumors. There were 12 recurrences during the median follow-up intervals of 42.7 months. Stage, grade, histologic type, lymphovascular space invasion (LVSI), and ploidy were significantly correlated with recurrence-free interval by univariate Cox analysis. Based on multivariate Cox analysis, ploidy was an independent prognostic factor, with a hazard ratio of 4.5 (95% confidence interval [CI], 1.3-15.3; P=0.017) adjusted for stage, grade, histologic type, and LVSI. In low-risk patients (n=156), the recurrence rate was 2.1% for diploid tumors and 12.5% for aneuploid tumors (P=0.038).
  
  
  CONCLUSIONS
  DNA aneuploidy is an independent prognostic factor in patients with endometrial cancer and can identify high-risk patients among those considered 'low-risk' with stage I endometrial cancer.
authors.affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Republic of Korea.
authors.forename: Taejong
authors.initials: T
authors.lastname: Song
authors.forename: Jeong-Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Ha-Jeong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Min Kyu
authors.initials: MK
authors.lastname: Kim
authors.forename: Chel Hun
authors.initials: CH
authors.lastname: Choi
authors.forename: Tae-Joong
authors.initials: TJ
authors.lastname: Kim
authors.forename: Duk-Soo
authors.initials: DS
authors.lastname: Bae
authors.forename: Byoung-Gie
authors.initials: BG
authors.lastname: Kim
mesh_terms: D004273:DNA, Neoplasm / Q000235:genetics*; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000235:genetics* / Q000473:pathology* / Q000601:surgery; D005260:Female; D005434:Flow Cytometry; D020022:Genetic Predisposition to Disease; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000235:genetics / Q000473:pathology; D009367:Neoplasm Staging; D011003:Ploidies; D012189:Retrospective Studies
chemical_list: D004273:DNA, Neoplasm