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Prognostic importance of DNA-ploidy and S-phase fraction in endometrial cancer

On fresh frozen tumor tissue from 161 patients with endometrial cancer DNA-ploidy and S-phase fraction were measured in a prospective study to evaluate their prognostic and predictive value. All FIGO stage I or II patients had surgery and were included in an adjuvant trial comparing tamoxifen 30 mg...

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Hauptverfasser: Minckwitz, Gunter von (VerfasserIn) , Kühn, W. (VerfasserIn) , Kaufmann, Manfred (VerfasserIn) , Feichter, Georg E. (VerfasserIn) , Heep, Josef (VerfasserIn) , Schmid, Hans (VerfasserIn) , Bastert, Gunther (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: July 01, 1994
In: International journal of gynecological cancer
Year: 1994, Jahrgang: 4, Heft: 4, Pages: 250-256
ISSN:1525-1438
DOI:10.1046/j.1525-1438.1994.04040250.x
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1046/j.1525-1438.1994.04040250.x
Verlag, lizenzpflichtig, Volltext: https://ijgc.bmj.com/content/4/4/250
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Verfasserangaben:G. von Minckwitz, W. Kühn, M. Kaufmann, G.E. Feichter, J. Heep, H. Schmid, G. Bastert

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520 |a On fresh frozen tumor tissue from 161 patients with endometrial cancer DNA-ploidy and S-phase fraction were measured in a prospective study to evaluate their prognostic and predictive value. All FIGO stage I or II patients had surgery and were included in an adjuvant trial comparing tamoxifen 30 mg p.o. versus medroxyprogesterone acetate 500 mg p.o. for 2 years versus no therapy. Diploid (DNA index (DI) ⩽ 1.1) tumors were found in 75%. S-phase fraction was elevated (>5%) in 46 (30%) of the patients. Significant correlations of DNA-ploidy and S-phase fraction were found with classical parameters such as stage, grade, histologic type and estrogen and progesterone receptor status. Patients with FIGO stage I aneuploid tumors showed significantly shorter disease-free interval (DFS) and overall survival (OAS). Recurrences and deaths occurred more often in tumors with raised S-phase fraction. In these early stages clinical outcome was worst if both factors were unfavorable. In multivariate analysis of stage I tumors DNA-ploidy and S-phase fraction were independent of grade, type and estrogen receptor status. Patients whose tumors had elevated S-phase fractions (>5%) gained more benefit from endocrine treatment than patients with low S-phase fractions. Patients with diploid and aneuploid tumors had prolonged DFS and improved OAS, if they had received adjuvant hormonal therapy. In endometrial cancer, DNA-ploidy and S-phase fraction are objective and reliable prognostic and predictive parameters which should be integrated into the clinical management. 
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