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Published on: September 12, 2019
Preoperative anemia, leukocytosis and thrombocytosis identify aggressive endometrial carcinomas
Tormund S Njølstad1, Hilde Engerud, Henrica M J Werner
1Department of Clinical Science, University of Bergen, Haukeland University Hospital, 5021 Bergen, Norway.
Objectives:
The objective of this study is to investigate preoperative hematological parameters for anemia, leukocytosis and thrombocytosis in relation to established prognostic factors and survival in endometrial cancer.
Methods:
557 patients treated for endometrial carcinoma were prospectively included in a study focusing on the relationship between preoperative hemoglobin, leukocyte and platelet counts, and a panel of clinicopathological characteristics and outcome.
Results:
Preoperative anemia was present in 15.8%, leukocytosis in 11.2% and thrombocytosis in 12.1%. Among patients with localized disease (FIGO stage I/II), 18.1% had anemia and/or thrombocytosis at diagnosis. Patients with advanced disease (high FIGO stage and lymph-node metastasis) had significantly lower hemoglobin count, higher leukocyte count and higher platelet count (all p<0.008). Patients with anemia, leukocytosis and thrombocytosis had significantly shorter 5-year disease-specific survival of 61.3%, 66.0% and 61.0% respectively, compared to 87.7%, 86.3% and 87.3% for patients with normal counts (all p<0.001). In multivariate Cox regression analysis, lower hemoglobin counts and higher platelet counts were independently associated with poor outcome adjusted for the standardly applied prognostic markers (p<0.033).
Conclusion:
Preoperative anemia, leukocytosis or thrombocytosis in women with endometrial carcinoma is associated with advanced disease and poor disease-specific survival.
