Identification of patients with stage I uterine endometrioid adenocarcinoma at high risk of recurrence by DNA ploidy, myometrial invasion, and vascular invasion

The presence of vascular invasion-associated changes (VIAC), which include vascular invasion by tumor and/or the presence of myometrial perivascular lymphocytic infiltrates, has been previously described as a key prognostic indicator in patients with stage I endometrioid (typical) adenocarcinoma of the uterus. In the current report, the prognostic significance of DNA ploidy in addition to other clinical and pathologic features including VIAC was determined in 57 previously examined stage I endometrioid adenocarcinomas of the uterine corpus. By univariate analysis, age at the time of diagnosis, architectural and nuclear tumor grades, DNA ploidy, depth of myometrial invasion, and the presence of VIAC all correlated with clinical outcome. By multivariate survival analysis, only the depth of myometrial invasion, DNA ploidy, and VIAC were found to significantly correlate with survival. A statistical model based on these three features permits stratification of patients into four risk groups with 93, 67, 38, and 10% survival, respectively.