Peritoneal cytology and preoperative serum CA 125 level are important prognostic indicators of overall survival in advanced endometrial cancer.

The current study aimed to evaluate flow cytometry findings, peritoneal cytology and preoperative CA 125 level as prognostic factors of endometrial carcinoma.A retrospective study of 44 patients with FIGO stage II-IV endometrial carcinoma who underwent abdominal hysterectomy, bilateral salpingo-oophorectomy and, all except three, pelvic lymph node dissection. At operation, a peritoneal washing sample was taken for cytological examination. Flow cytometry was performed on fresh primary tumor samples. Blood samples were obtained within 2 weeks before surgery. The median follow-up time was 54 months.In univariate analysis, DNA ploidy, S-phase fraction, serum CA 125 level and peritoneal cytological findings correlated significantly with survival. In multivariate analysis, peritoneal cytology (benign versus malignant), grade (1 + 2 versus 3) and preoperative serum CA 125 concentration (< or = 25 U/ml versus > 25 U/ml) remained significant independent predictors of overall survival. DNA ploidy and S-phase fraction had a strong correlation with peritoneal cytology. Malignant cytological findings were more frequent in cases with DNA aneuploidy and S-phase fraction higher than 8%.In addition to histological grade, peritoneal cytology and preoperative serum CA 125 level were also important independent prognostic indicators of outcome.