Hematologic counts and clinical correlates in 1201 newly diagnosed lung cancer patients

Many factors have prognostic significance in lung cancer. However, their practical value remains controversial except for stage of disease, performance status, and, perhaps, weight loss.

In the present study, counts of platelet (P), leukocyte (L), neutrophil (N), and hemoglobin serum content (Hb) were analyzed in 1201 new consecutive lung cancer patients. A set of 28 anthropometric, clinical, physical, laboratory, radiological, and pathological variables was prospectively recorded for all patients. Patients were carefully followed-up, and their subsequent clinical course recorded.

Anemia, leukocytosis, and thrombocytosis were present in 56%, 32%, and 17% of patients, respectively. Correlation tests showed that P was significantly correlated with L, N and Hb (rs = 0.353, 0.352, and -0.295, respectively). Other significant associations were those between Hb and Karnofsky Performance Status (KPS) (rs = 0.232), weight loss (rs = -0.210), and serum protein (rs = 0.263). N and L were correlated with KPS (rs = -0.217 and -0.186), stage of disease (rs = 0.153 and 0.135) and number of metastasis (rs = 0.121 and 0.109). Univariate analyses of survival showed that: a) abnormal values of L were prognosticantly significant in adenocarcinoma (p < 0.0001); b) patients with Hb < 13 g/dL had significantly shorter survivals (p = 0.0002); and c) thrombocytosis was associated to a poor outcome in patients with adenocarcinoma and epidermoid cancers (p = 0.0061 and 0.0072, respectively). The multivariate model selected, in decreasing order of significance, the following variables: 1) stage of disease; 2) KPS; 3) neutrophils; 4) age; and 5) sex.

This data indicates that only the leukocyte counts is an independent prognostic factors of survival in lung cancer.