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dc.contributor.authorNjølstad, Tormund Salvesenen_US
dc.contributor.authorTrovik, Joneen_US
dc.contributor.authorHveem, Tarjei Sveinsgjerden_US
dc.contributor.authorKjæreng, Marna Lillen_US
dc.contributor.authorKildal, Wanjaen_US
dc.contributor.authorPradhan, Manoharen_US
dc.contributor.authorMarcickiewicz, Januszen_US
dc.contributor.authorTingulstad, Solveigen_US
dc.contributor.authorStaff, Anne Cathrineen_US
dc.contributor.authorHaugland, Hans Kristianen_US
dc.contributor.authorEraker, Runaren_US
dc.contributor.authorOddenes, Klausen_US
dc.contributor.authorRokne, Jan Andersen_US
dc.contributor.authorTjugum, Josteinen_US
dc.contributor.authorLode, Margaret Sæviken_US
dc.contributor.authorAmant, Frédéricen_US
dc.contributor.authorWerner, Henrica Maria Johannaen_US
dc.contributor.authorSalvesen, Helga Birgitteen_US
dc.contributor.authorDanielsen, Håvard Emilen_US
dc.PublishedBritish Journal of Cancer 2015, 112:1656-1664eng
dc.description.abstractBackground: Preoperative risk stratification is essential in tailoring endometrial cancer treatment, and biomarkers predicting lymph node metastasis and aggressive disease are aspired in clinical practice. DNA ploidy assessment in hysterectomy specimens is a well-established prognostic marker. DNA ploidy assessment in preoperative curettage specimens is less studied, and in particular in relation to the occurrence of lymph node metastasis. Methods: Curettage image cytometry DNA ploidy in relation to established clinicopathological variables and outcome was investigated in 785 endometrial carcinoma patients prospectively included in the MoMaTEC multicentre trial. Results: Diploid curettage status was found in 72.0%, whereas 28.0% were non-diploid. Non-diploid status significantly correlated with traditional aggressive postoperative clinicopathological features, and was an independent predictor of lymph node metastasis among FIGO stage I–III patients in multivariate analysis (OR 1.94, P=0.033). Non-diploid status was related to shorter disease-specific survival (5-year DSS of 74.4% vs 88.8% for diploid curettage, P<0.001). When stratifying by FIGO stage and lymph node status, the prognostic effect remained. However, in multivariate regression analysis, preoperative histological risk classification was a stronger predictor of DSS than DNA ploidy. Conclusions: Non-diploid curettage is significantly associated with aggressive clinicopathological phenotype, lymph node metastasis, and poor survival in endometrial cancer. The prognostic effect was also observed among subgroups with (presumably) less aggressive traits, such as low FIGO stage and negative lymph node status. Our results indicate curettage DNA ploidy as a possible supplement to existing parameters used to tailor surgical treatment.en_US
dc.publisherNature Publishing Groupeng
dc.subjectEndometrial cancereng
dc.subjectDNA ploidyeng
dc.subjectlymph node metastasiseng
dc.titleDNA ploidy in curettage specimens identifies high-risk patients and lymph node metastasis in endometrial canceren_US
dc.typePeer reviewed
dc.typeJournal article
dc.rights.holderCopyright 2015 Cancer Research UK.
dc.relation.projectNorges forskningsråd: 223250
dc.relation.projectNorges forskningsråd: 239840
dc.relation.projectNorges forskningsråd: 205404
dc.subject.nsiVDP::Medisinske fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710::Generell patologi, patologisk anatomi : 719
dc.subject.nsiVDP::Midical sciences: 700::Basic medical, dental and veterinary sciences: 710::General pathology, anatomical pathology: 719
dc.subject.nsiVDP::Medisinske Fag: 700en_US

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