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PubMedDate not supplied

Postmenopausal estrogen replacement therapy is associated with adverse breast cancer prognostic indices.

Previous studies have reported that breast cancer patients who used estrogen replacement therapy (ERT) have more favorable tumor characteristics and decreased mortality compared with nonusers. However, these findings may be due partly to increased medical surveillance in ERT users and detection of early stage tumors. Postmenopausal women with biopsy-proven breast cancer (n = 108) were identified based on their participation in screening mammography. Based on self-administered questionnaires completed at the time of mammography, 29 of these were users of ERT. Tumor characteristics (histology size, nodal status, and estrogen receptor content) of ERT users were compared with those of nonusers. After adjusting for potentially confounding variables, the odds ratios (OR) describing the relationship between ERT use and the risk of invasive histopathology (OR = 1.35, 95% CI = 0.48, 3.75), positive nodes (OR = 2.43, 95% CI = 0.59, 10.10), size > or = 2.0 cm (OR = 2.34, CI = 0.66, 8.27), or negative estrogen receptor status (OR = 1.08, 95% CI = 0.18, 9.38) were > 1, although none reached statistical significance. When the subjects were separated into two prognostic groups based on the presence or absence of adverse prognostic indices, ERT users had a statistically significantly increased risk of being in the poor prognostic group (tumor size > or = 2.0 cm or positive nodes or negative estrogen receptor content) (OR = 4.48, 95% CI = 1.10, 18.30). The risk was highest in current users (OR = 6.28, 95% CI = 1.16, 34.00), users for 5 or more years (OR = 7.77, 95% CI = 1.09, 55.60), and users of nonconjugated estrogen (OR = 9.63, 95% CI = 1.18, 78.60). Although our sample size is small and we do not currently have information on long-term outcomes, the findings from this screening population suggest that ERT may have an adverse effect on important breast cancer prognostic indices.

Aged↗
PubMed1995

Immunohistochemical detection of p53 protein as a prognostic indicator in prostate cancer.

Mutation of the p53 gene is the most common genetic alteration in human cancers. The mutant p53 protein is more stable than the wild type and can be detected by immunohistology. The objective of the current study was to evaluate the immunohistological detection of p53 protein in prostate cancer and its utility as a prognostic indicator. We used a monoclonal anti-p53 antibody and immunostained primary prostate adenocarcinomas (stages A1 to D1) from 109 patients with a mean follow-up of 3.8 years (range, 1.3 to 9.3 years). Immunoreactivity for p53 was seen in 23 cancers (21%). There were 12 instances of progression (14%) among the p53-negative cancers versus seven (30%) among the p53-positive group. Survival analysis using three univariate statistical tests showed that p53 reactivity (P < .03), Gleason score (P < .01), and stage (P < .05) had significant effects on time to progression of prostate cancer. Multivariate analyses showed that Gleason score was significant with all three tests; p53 reactivity was significant with the Wilcoxon test but only approached significance by the log rank and Cox tests. When the analyses included only patients with Gleason scores 2 to 7 (N = 94), univariate analyses showed that p53 reactivity was strongly related to progression of prostate cancer (P < .007). Stage also was significant (P < 0.04), but Gleason score was not. Multivariate analyses showed only p53 reactivity to be significant (P < .007). In conclusion, mutation of the p53 gene may be involved in prostate cancer carcinogenesis. p53 reactivity marks an aggressive subset of prostate cancer and appears to be an independent prognostic indicator that is particularly valuable among the low to intermediate grade cancers.

Aged↗
PubMed1994

Prediction of axillary lymph node status in breast cancer patients by use of prognostic indicators.

BACKGROUND: If axillary lymph node status of breast cancer patients could be accurately predicted from basic clinical information and from characteristics of their primary tumors, then many patients could be spared axillary lymph node dissection. Tumor size alone does not allow the identification of groups with very low or high risk of being axillary node positive. PURPOSE: Our goal was to investigate the possibility of using prognostic indicators to predict axillary node status of patients with primary breast cancer. METHODS: Data from 26,683 patients from the National Breast Cancer Tissue Resource were used in this study. Patients in this dataset were randomly assigned to a training set (patient information used to construct predictive models) or a validation set (patient information used to prospectively evaluate predictive models). The records of a total of 11,964 case patients that had complete prognostic factors and pathologic data were analyzed: 5963 patients in the training set and 6001 patients in the validation set. All of the patients studied had tumors 5 cm or less in size and at least 15 axillary lymph nodes that had been examined. Data used for construction of the predictive models were available for all patients and included tumor size, number of nodes positive, patient age, quantitative estrogen receptor levels, quantitative progesterone receptor (PgR) levels, DNA flow cytometry-derived ploidy, and S-phase fraction. Logistic regression models were used to predict nodal status. RESULTS: Multivariate predictive models were produced that used tumor size, patient age, S phase, and PgR as independent predictors. These models allowed identification of patient risks of being node positive ranging from 6%-79% and as having 10 or more positive nodes ranging from less than 1% to slightly more than 30%. CONCLUSION: Addition of prognostic indicator information to tumor size can refine estimates of whether a patient is likely to be node positive. However, no patient subsets could be identified as having greater than 95% chance of being node negative or node positive. IMPLICATIONS: These predictive models cannot alleviate the necessity of axillary node dissection for staging of breast cancer patients in situations in which nodal status would affect therapeutic decisions. Subsets of patients could be identified who had a less than 5% chance of having 10 or more positive nodes. Thus, some patients could be spared axillary dissection if it was being performed solely to identify patients with this high-risk feature.

Axilla↗
PubMed2006

Clinicopathological features, post-surgical survival and prognostic indicators of elderly patients with hepatocellular carcinoma.

AIM: Comprehensive data regarding elderly patients with hepatocellular carcinoma (HCC) were limited. The present study aims to widen the knowledge based on patients in China. METHODS: Fifty-four elderly (> or =65 years) and 125 non-elderly HCC patients undergoing hepatectomy were enrolled in this retrospective study. Clinicopathological features and post-surgical survival were compared between two groups. Prognostic indicators of elderly patients were defined by uni- and multivariate analyses. RESULTS: Contrast to non-elderly patients, the elderly presented significantly lower rates of HBsAg positivity, Child-Pugh grade A, alpha-fetoprotein (AFP) marked elevation, portal vein tumour thrombosis (PVTT), satellite nodule, and intrahepatic recurrence, smaller tumour sizes, earlier TNM staging and better histological differentiation. No significant differences were found in perioperative mortality rate and post-surgical survival between two groups. PVTT and Edmondson-Steiner grading were identified as independent prognostic indicators of both overall and disease-free survival by multivariate analysis, whereas Child-Pugh grading independently affected the overall survival. CONCLUSIONS: HCC in the elderly seemed to be less HBV-associated, less progressive and less aggressive than that in the non-elderly. Hepatectomy for the elderly could make a satisfactory prognosis and be well tolerated. Some tumour-related factors independently predict the prognosis of elderly HCC patients, and their liver function status should be further valued.

Aged↗
PubMed1990

Serum triiodothyronine values. Prognostic indicators of acute mortality due to Pneumocystis carinii pneumonia associated with the acquired immunodeficiency syndrome.

A feasibility study was undertaken prospectively to identify early clinical and laboratory factors predictive of acute hospital mortality in patients with the acquired immunodeficiency syndrome and concurrent Pneumocystis carinii pneumonia. Twenty-six patients hospitalized with bronchoscopy-proved P carinii pneumonia were studied. Nineteen patients survived their episode of P carinii pneumonia, while 7 subjects did not. The only clinical factor associated with mortality was a history of a shorter duration of pulmonary symptoms. Univariate analysis showed decreased total CD8 cell count, total lymphocyte count, serum hemoglobin, serum albumin, total thyroxine, and total triiodothyronine values consistent with a poor outcome. Multivariate logistic regression analysis showed that the single best prognostic indicator of acute mortality appeared to be a total serum triiodothyronine value less than 0.70 nmol/L obtained early in the hospital course, and that the combination of serum triiodothyronine and hemoglobin values provided a better indication for survival. These preliminary observations would appear to justify the further exploration of serial serum triiodothyronine measurements as a potentially valuable prognostic indicator for the treatment of patients with acquired immunodeficiency syndrome infected with P carinii and possibly other intercurrent infectious illnesses.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Prognostic indicators for neuroblastoma: stage, grade, DNA ploidy, MIB-1-proliferation index, p53, HER-2/neu and EGFr--a survival study.

Neuroblastoma, a tumor of the sympathetic nervous system, is one of the most common solid malignancies in infants and represents 7% of all cases of childhood cancer outside of the central nervous system. Thirty-five samples of neuroblastoma from 31 patients were obtained from Duke University Medical Center between 1979 and 1991 and studied to determine the relative prognostic value of a number of clinical, histologic, nuclear, and oncogenic features. The features studied were: stage, Shimada classification, DNA ploidy, MIB-1-proliferation index and status for HER-2/neu, p53 and epidermal growth factor receptor (EGFr). Only age (P = .03), HER-2/neu (P = .01), and p53 (P = .02) reached statistical significance as prognostic indicators. The median survival for patients with HER-2/neu expression was 12 months; median survival for patients with no HER-2/neu expression was 138 months. Similarly, the median survival for patients with p53 expression was 12 months; patients with no p53 expression had a median survival was 144 months. The combination of either HER-2/neu or p53 positivity was especially strong as a prognostic indicator (P = .002).

Antibodies, Monoclonal↗
PubMed2005

Prognostic indicators for survival in head and neck squamous cell carcinomas: analysis of a series of 621 cases.

BACKGROUND: We sought to study the influence of pT classification, pN status, tumor volume, and number of lymph nodes invaded on survival of patients with head and neck cancers to improve therapeutic indications. METHODS: This was a retrospective study of 621 consecutive patients treated from 1990 to 1997 by a single team. RESULTS: In univariate analysis, pT classification (p < .0001), pN status (p < .0001), capsule rupture (p < .0001), the number of lymph nodes invaded (0, 1-3, 4-9, > or =10) (p < .0001), and the tumor volume (p < .0001) were significantly associated with overall survival. A Cox model identified as independent prognostic indicators age (p < .0001), pT classification (p < .0001), and pN status (p < .0001). CONCLUSIONS: Not only pT classification and pN status but also the number of the lymph nodes invaded and the tumor volume should be considered as essential prognostic indicators, and any clinical trial developed should stratify accordingly.

Adult↗
PubMedDate not supplied

Prognostic indices in endometrial adenocarcinoma stages I and II. A study based on clinical, histopathological and flow cytometric variables.

In a prospective study including 447 patients with endometrial adenocarcinoma stages I and II, clinical and flow cytometric variables were studied in univariate and multivariate analyses. During the follow-up period of 3 to 65 months, 41 patients died of their disease and 26 patients died of intercurrent disease. Based on the results of multivariate analyses, five different prognostic indices were constructed. Using these indices, individual index values were calculated for each patient. The index values were correlated with survival and were used to identify a small high-risk group (10% of the patients) and a large low-risk group (90% of the patients). Indices 1 and 2 were constructed for pre-treatment situations. Index 1 included age and histopathologic grade and identified a small high-risk group and a large low-risk group with a 3-year survival of 62% and 91% respectively. Index 2 also comprised S-phase fraction and distinguished a high-risk group with a 3-year survival of 54% from a low-risk group with a 3-year survival of 93%. Indices 3 and 4 were constructed for patients after surgery, when the degree of residual myometrial tumor invasion was known. Index 3 included age, histopathologic grade and residual myometrial invasion rendering a 3-year survival of 44% and 93% for the high- and low-risk groups respectively. Index 4 also comprised S-phase fraction and identified a high-risk group and a low-risk group with 3-year survival figures of 59% and 96%, respectively. Index 5 included age and histopathologic grade and was constructed for post-treatment situations in unoperated patients. The index separated a high-risk group from a low-risk group with a 3-year survival of 56% and 88%, respectively. In summary, the results from our study show that the prognostic indices made it possible to identify high and low-risk groups in different clinical situations which may prove useful in selecting candidates for future trials with adjuvant or reduced treatment.

Adenocarcinoma↗
PubMed1999

Inability of bone turnover marker as a strong prognostic indicator in prostate cancer patients with bone metastasis: comparison with the extent of disease (EOD) grade.

BACKGROUND: Although clinical investigations of bone turnover markers in prostate cancer patients have been conducted, the relationships of pretreatment levels of the markers to the prognosis of patients with bone metastasis has not been fully examined. METHODS: The serum levels of carboxy-terminal propeptide of type I procollagen (PICP) and carboxy-terminal telopeptide of type I collagen (ICTP), alkaline phosphatase (ALP), and prostate-specific antigen (PSA) were examined in 48 untreated prostate cancer patients with bone metastasis, and the prognoses of the patients were evaluated using univariate and multivariate analyses. RESULTS: The patients with low PICP or ALP values had significantly better outcomes in terms of cause-specific survival compared to the patients with high PICP or ALP values. There was no significant difference in survival between patients with high and low ICTP or PSA values. The multivariate analysis of PICP, ICTP, ALP, PSA, and extent of disease (EOD) grade revealed that only the EOD grade was an important prognostic indicator for survival. CONCLUSIONS: These results demonstrate that the extent of bone metastasis evaluated by bone scintigrams is a more important prognostic indicator than are the serum biochemical markers of bone turnover.

Aged↗
PubMed2000

p53 and bcl-2 in epithelial ovarian carcinoma: their value as prognostic indicators at a median follow-up of 60 months.

OBJECTIVE: p53 is the most common tumor suppressor gene involved with human malignancies. Mutations in p53 are present in approximately 50% of human malignancies. bcl-2 is a protooncogene. Expression of its protein product is related to better prognosis in several malignancies. METHODS: One hundred and three patients with epithelial ovarian carcinoma were studied. Immunohistochemical staining using the pAb1801 monoclonal antibody to p53 and the anti-bcl-2 124 monoclonal antibody to bcl-2 was performed. Image analysis was used to measure percentage positive nuclear area staining of mutant p53. In addition to bcl-2 and p53, FIGO stage, grade, histology, and level of cytoreduction were analyzed as prognostic factors. Univariate as well as Cox regression analysis was performed. RESULTS: One hundred and three patients were followed for a mean of 60 months. Twenty patients had FIGO stage I disease, 4 stage II, 59 stage III, and 20 stage IV. Immunohistochemical staining for mutant p53 was not significantly related to DNA index (P = 0.99) but was related to increasing FIGO stage (P < 0.001) and increasing histologic grade (P = 0.039). Using Cox regression analysis, increased mutant p53 staining was an independent predictor of survival in these patients (P = 0.0032), along with stage (P < 0. 0001) and level of cytoreduction (P < 0.0001). Although by itself bcl-2 was not an independent prognostic indicator (P = 0.18), the combination of p53 and bcl-2 was independently predictive of survival (P = 0.038). CONCLUSION: This study confirms the authors' earlier report on the importance of p53 as a prognostic indicator of survival in ovarian carcinoma. Cox regression analysis reveals mutant p53 staining to be a better independent indicator of prognosis and survival in patients with ovarian carcinoma than the combination of bcl-2 and p53.

Adult↗
PubMed1989

Oestrogen and progestin receptors as prognostic indicators in endometrial cancer. A review of the literature.

The history of research on oestrogen and progestin receptors in endometrial cancer goes back about 20 years. Summarized data from several clinical studies demonstrate that cytosol oestrogen (ERC) and progestin receptors (PRC) are clinically useful indicators of prognosis. Absence of receptor or its low concentration is indicative of an increased risk of recurrent malignancy. In this respect PRC tends to be more sensitive than ERC. In some studies PRC assay appeared to be more strongly correlated to prognosis than any of the conventional clinico-pathological parameters. In addition, the information obtained by ERC and/or PRC assay is independent of and additional to the classical prognostic indicators. The value of ERC and PRC assay in predicting the sensitivity of endometrial cancer to progestin therapy is of clinical interest. The accumulated data for many clinical trials show that in detecting the non-responders to progestin therapy negative results of ERC and PRC give similar information with an accuracy of about 90%. In identifying responders to progestin therapy, a positive PRC result appeared to give more precise information than a positive ERC, the accuracy being about 75% for PRC. The use of the combination of ERC and PRC determination as a prognostic indicator or predictor of sensitivity to progestin therapy does not significantly increase the information available by PRC measurement alone. Hence, whatever used--a biochemical ligand binding technique or immunohistochemical staining--PRC determination alone seems recommendable for clinical purposes.

Female↗
PubMed2001

Quantitative p21(waf-1)/p53 immunohistochemical analysis defines groups of primary invasive breast carcinomas with different prognostic indicators.

We used image cytometry to quantify the immunohistochemical expression of p21(waf-1) and p53 in primary breast carcinoma. Ratio analysis of the quantified p53/p21(waf-1) protein expression allowed us to define 3 groups of carcinomas, each characterized by specific pathological and biological profiles. The negative (NEG) group, characterized by negligible expression of both proteins, comprised small-sized, low-grade tumors associated with high contents of hormonal receptors and low growth fraction. In the NEG group, Ki-67 labelling index area (%LIa) was the only significant prognostic indicator. The P53H group, characterized by prevalence of p53 %LIa, was constituted by large-sized, high-grade tumors showing low hormonal receptor contents and high growth fraction. In the P53H group, both p53 and Ki-67 were inversely associated with both estrogen receptor (ER) and progesterone receptor (PGR), suggesting that extensive p53 immunostaining is related to poor differentiation and high proliferation. Only N status was prognostically significant in the P53H group. The P21H group, characterized by prevalence of p21(waf-1) %LIa, displayed intermediate pathological and biological features. A significant association between p53 and p21(waf-1) expression suggested functional stabilization of wtp53 and therefore possible DNA damage-dependent G1/S arrest (genetic instability) in the P21H group; P21(waf-1)expression was significantly associated with the presence of node metastasis. Patients in the P21H group had a higher recurrence rate and a shorter disease-free time interval from surgery with respect to the NEG group. Proportional hazard regression analysis disclosed Ki-67 %LIa and, to a lesser degree, PGR %LIa as significant relapse-free survival prognostic indicators.

Adult↗
PubMed1994

Prognostic indicators in bulimia nervosa treated with cognitive-behavioral group therapy.

Prognostic indicators of short-term outcome were identified in 69 women with the DSM-III-R diagnosis of bulimia nervosa who participated in a weekly 10-session structured cognitive-behavioral outpatient group program. Prior to treatment, all subjects completed the computerized Diagnostic Interview Schedule (DIS), the Moos Family Environment Scale (FES), the Diagnostic Survey for Eating Disorders (DSED), the Beck Depression Inventory (BDI), the Hopkins Symptom Checklist, Revised (SCL-90-R), the Bulimic Cognitive Distortions Scale (BCDS), the Eating Disorders Inventory (EDI), and the Bulimic Symptoms Checklist (BSCL). The latter three scales were readministered on completion of the 10-week group. Symptom improvement was assessed by examining percentage reduction in binge frequency, purge frequency, and summed scores for the EDI subscales Bulimia, Drive for Thinness, and Body Dissatisfaction. The only significant predictor of improvement in binge frequency and bulimic cognitions was family environment. Conflicted, controlling, and over-organized family environments appear to impede both reductions in binge frequency and changes in bulimic cognitions. Reduction in vomit frequency was associated with weight history and with laxative or diuretic use. The implications for planning psychotherapeutic interventions in bulimia nervosa are discussed.

Adolescent↗
PubMed2003

Quantitative prognostic indicators of peritoneal surface malignancy: carcinomatosis, sarcomatosis, and peritoneal mesothelioma.

Quantitative prognostic indicators for carcinomatosis and sarcomatosis are essential in the management of peritoneal surface malignancy. This need is greatly accentuated as a new comprehensive therapeutic approach emerges. The assessment of tumor histopathology, prior surgical score, lesion size, and distribution (Gilly classification and peritoneal cancer index) and the completeness of cytoreduction scores are the tools that are currently in use. Although current assessments have greatly facilitated clinical research, more precise comparisons demand improved quantitation and greater precision. Preoperative and intraoperative assessment of peritoneal surface malignancy will improve patient selection. Now more than ever, postoperative distribution and volume assessments using noninvasive modalities are needed for follow-up.

Adult↗
PubMed1992

Coagulation factor V and VIII/V ratio as predictors of outcome in paracetamol induced fulminant hepatic failure: relation to other prognostic indicators.

The value of coagulation factor V and VIII/V levels as prognostic indicators was assessed in 27 patients with fulminant hepatic failure and compared with other predictive indices. Admission factor V levels were significantly reduced in 22 patients with paracetamol induced hepatic failure compared with a healthy control group (median 9.5% v 103%, respectively; p less than 0.001) and with lower values in non-A non-B hepatitis (median 2.7%). Values in the seven patients who died after paracetamol overdose, considered together with the four who underwent liver transplantation (group median 5.1%), were significantly lower than in the 11 who survived (median 11.8%; p less than 0.01). Median admission factor VIII was higher in those who died or received a transplant than in those who survived (298% v 162%; p less than 0.05), with both results higher than in healthy volunteers (median 104%; p less than 0.01) but lower than in non-A non-B hepatitis (median 340%). The ratio of factor VIII/V on admission was less than 30 in all patients who survived paracetamol overdose (median 17) with corresponding values greater than 30 in 10 of 11 of those who died (median 39). A factor V result less than or equal to 10% on admission predicted an adverse outcome in 10 of 11 fatal cases, a 91% sensitivity which was greater than for the previously defined indicator of an arterial blood pH less than 7.30 on admission (sensitivity 82%). Prothrombin time at admission or on day 4 did not usefully predict outcome in our series. Predictive accuracy was 73% and 82% for factor V and admission acidosis respectively and 95% for factor V in conjunction with admission coma grade III or IV and factor VIII (ratio > 30). These criteria may be useful in selecting patients with paracetamol induced fulminant hepatic failure for transplantation.

Acetaminophen↗
PubMed1992

Fetal pleural effusion: a review and meta-analysis for prognostic indicators.

We reviewed the literature on fetal pleural effusion to identify prognostic indicators related to outcome. Data on 124 cases from 38 reports were collected and analyzed using chi 2 statistical analysis and stepwise multiple logistic regression. Termination of pregnancy occurred in ten cases, spontaneous resolution occurred in 11 cases with 100% survival, and overall mortality was 46%. Gestational age at delivery of greater than 31 weeks, the absence of hydrops, and the use of antenatal therapy (thoracentesis or shunt placement) were associated with good outcome. Gender of the fetus, hydramnios, extent of effusion as unilateral or bilateral, and mode of delivery were not significantly related to outcome. Recommendations for evaluation include search for other abnormalities and possible causes related to hydrops. Management is guided by gestational age and the presence of hydrops. Antenatal therapy is recommended if hydrops develops, particularly at a gestational age of less than 32 weeks.

Fetal Diseases↗
PubMed1999

Perioperative blood transfusion as a prognostic indicator in patients with hepatocellular carcinoma.

We studied the relation of perioperative blood transfusion and the outcomes in 175 patients with hepatocellular carcinoma (HCC) who underwent hepatic resection from 1986 to 1994 in our hospital. Hepatectomy was performed in 23 (13.1%) patients with and 152 (86. 9%) without blood transfusions. The cumulative cancer-free survival rates for patients who had received blood transfusion was significantly lower than that for patients who had not received blood transfusions (p = 0.003). Further examinations revealed a significant difference in cancer-free survival rates for stage I-II patients (n = 75) of HCC (p = 0.02) but not for stage III-IV patients (n = 56) (p = 0.06). Cox regression analysis for recurrence revealed that blood transfusion was the most significant prognostic indicator (p = 0.001) for recurrence in stage I-II patients but not in stage III-IV patients (p = 0.99). These results suggest that a perioperative blood transfusion may be a significant prognostic indicator for patients with HCC who had underwent hepatectomy, especially in stage I-II patients of HCC.

Adult↗
PubMed1996

p53 as a prognostic indicator in endometrial cancer.

BACKGROUND: One of the most common genetic alterations to occur in human cancers is an alteration of the p53 tumor suppressor gene. Although endometrial cancer is the most common gynecologic malignancy in the United States, any connection between it and p53 is just beginning to be explored. METHODS: Forty-six consecutively surgically treated patients with endometrial cancer had their p53 expression studied by immunoperoxidase staining and quantified by image analysis. RESULTS: Thirty-five patients had endometrioid adenocarcinomas, 3 had adenosquamous carcinomas, 3 had papillary serous carcinomas, 3 had clear cell carcinomas, and 2 had undifferentiated carcinomas. p53 expression ranged from 0.0 to 55.8% with a mean of 10.7% for the cohort. For the patients with endometrioid carcinomas, the mean p53 expression was 3.9%, while for those with more aggressive histologies it was 32.4% (P < 0.001). Sixteen of the 35 endometrioid tumors (45.7%) stained positive for p53, while 11 of the remaining 12 (91.2%) tumors with more aggressive histologies stained positive (P < 0.01). Increasing histologic grade correlated with an increasing p53 expression (P = 0.006). The percentage of patient tumors expressing p53 was found to be higher in FIGO stage II, III, and IV than in FIGO stage I cancer (P = 0.01). However, the mean p53 expression was not different between early (stage 1) and advanced (stage 11, III, and IV) cancers (P = 0.55). Utilizing recurrence as the endpoint for multivariate analysis, FIGO stage and p53 expression were the only independent prognostic indicators found. CONCLUSION: p53 expression is more common in more aggressive histologic subtypes than in endometrioid adenocarcinomas. It is an independent prognostic indicator of disease recurrence.

Adult↗