Article Text

Download PDFPDF
Confirmation of the prognostic value of the ECPI-1 score (myometrial invasion, DNA-ploidy and mean shortest nuclear axis) in FIGO stage I endometrial cancer patients with long follow-up
  1. J. P.A. BAAK*,
  2. W. P. SNIJDERS,
  3. P. J. VAN DIEST*,
  4. E. ARMEE-HORVÁTH* and
  1. *Free University Hospital, Institute of Pathology, Amsterdam
  2. Medical Centre Alkmaar, Department of Gynaecology and Obstetrics, Alkmaar
  3. Free University Hospital, Department of Obstetrics and Gynaecology, Amsterdam, the Netherlands
  1. Address for correspondence: Professor Dr J. P. A. Baak, Free University Hospital, Institute of Pathology, de Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.


In FIGO stage I endometrial cancer patients, histologic type and grade are correlated with prognosis and used for therapeutic decision making. However, assessment of these histologic features is subjective, and the results are not always perfectly reproducible. Contrarily, previous studies have shown that DNA-ploidy and morphometric features are highly reproducible and have a strong prognostic value in these cancers. Multivariate analysis has demonstrated that a combination of mean shortest nuclear axis (MSNA), DNA-ploidy and depth of myometrial invasion (the so-called ECPI-1 score) overshadowed the value of all other features investigated. The present study was set up to evaluate further and compare the prognostic power of the ECPI-1 score in 77 FIGO I patients with long follow-up (10–15 years). Grade (revised), invasion depth, MSNA and ploidy were all highly significant. However, the ECPI-1 score (with exactly the same threshold as in the previous study, 0.87) greatly exceeded the prognostic value of these single features. Only two (3%) of the 64 patients with ECPI-1 ⩽0.87 died (at 14 and 62 months), in contrast to 11 (84.6%) of the 13 cases with ECPI-1> 0.87 (10 died within 42 months) (P < 0.0001, Mantel-Cox value = 51.1). These results confirm the prognostic strength of the ECPI-1 score in stage I endometrial carcinoma.

  • DNA-ploidy
  • endometrial cancer
  • morphometry
  • prognosis

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.