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The role of flow cytometry in non-resected cervical carcinoma

¹ Department of Radiation Oncology, Chang-Gung Memorial Hospital, Tao-Yuan County, Taipei, Taiwan ² Department of Pathology, Chang-Gung Memorial Hospital, Tao-Yuan County, Taipei, Taiwan ³ Department of Radiation Therapy and Oncology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan

Flow cytometry (FCM) has a prognostic value for many malignant neoplasms in terms of treatment response rate and survival. However, its role in non-resected cervical carcinoma remains uncertain. We have collected 96 paraffin-embedded specimens taken from non-resected cervical cancer patients treated by radiotherapy (RT) alone between 1984 and 1986. Our data revealed that FCM has little correlation with patients' age, pathological grade and clinical stage. Ploidy pattern and clinical stage correlate significantly with complete remission (CR) rate (p = 0.001 and 0.03). Most diploid or low-stage tumours (I_B to II_A) obtained CR after RT alone. The application of an intravaginal extension electron cone (IVEC) (p = 0.019) and CR status (p = 0.0001) yield significant better overall survival (OS) rates than their alternative groups. The Cox regression model has confirmed these two variables as having an independent influence on OS. We thus conclude that both ploidy pattern and S-phase fraction (SPF) predict neither pre-treatment biological behaviour of the tumours nor overall survival. However, ploidy pattern has an independent influence on CR rate.

Received for publication March 11, 1994. Revision received September 12, 1994. Accepted for publication October 20, 1994.