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Annals of Oncology Advance Access originally published online on February 6, 2009
Annals of Oncology 2009 20(6):1037-1041; doi:10.1093/annonc/mdn765
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

gynecologic tumors

The prognostic value of DNA ploidy in a total population of uterine sarcomas

W. Kildal1,2, V. M. Abeler3, G. B. Kristensen1, M. Jenstad1,2, S. Ø. Thoresen4 and H. E. Danielsen1,2,5,*

1 Institute for Medical Informatics, Radiumhospitalet, Rikshospitalet University Hospital
2 Centre for Cancer Biomedicine, University of Oslo
3 Pathology Clinic, Radiumhospitalet, Rikshospitalet University Hospital
4 Cancer Registry of Norway
5 Department of Informatics, University of Oslo, Oslo, Norway

* Correspondence to: Prof. H. E. Danielsen, Institute for Medical Informatics, Radiumhospitalet, Rikshospitalet University Hospital, Montebello, N-0310 Oslo, Norway. Tel: +47-22-93-56-17; Fax: +47-22-93-56-27; E-mail: hdaniels{at}medisin.uio.no

Background: The diagnosis of uterine sarcoma is associated with poor outcome for the patient and there is a need for reliable prognostic markers. Most previous studies on the prognostic value of DNA ploidy include few uterine sarcomas and report conflicting results.

Materials and methods: We examined the prognostic value of DNA ploidy and its association with clinicopathological parameters and crude survival in a total population of 354 sarcoma.

Results: In univariate analyses, we observed significantly better crude survival for endometrial stromal sarcomas (ESS) and adenosarcoma (AS) patients with diploid as compared with nondiploid tumors, but not for patients with leiomyosarcomas (LMS). In Cox multivariate analyses, DNA ploidy was the only significant predictor of survival for patients with AS. In LMS, mitotic index (MI), tumor size, tumor extent and tumor margins, whereas for ESS, MI, tumor extent and tumor necrosis obtained independent significance of survival. DNA ploidy was a significant predictor of survival for LMS patients in Cox regression analyses when excluding MI.

Conclusion: DNA ploidy might be useful as a prognostic marker in patients with LMS and AS.

Key words: endometrial stromal sarcoma, leiomyosarcoma, DNA ploidy, prognostic factors, uterine sarcomas

Received for publication October 1, 2008. Revision received November 27, 2008. Accepted for publication November 28, 2008.


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