Preoperative anemia, leukocytosis and thrombocytosis identify aggressive endometrial carcinomas

Gynecol Oncol. 2013 Nov;131(2):410-5. doi: 10.1016/j.ygyno.2013.08.032. Epub 2013 Sep 1.

Abstract

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.

Keywords: Endometrial cancer; Leukocytosis; Preoperative anemia; Prognosis; Thrombocytosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anemia / blood
  • Anemia / etiology*
  • Anemia / pathology
  • Cohort Studies
  • Endometrial Neoplasms / blood*
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / surgery
  • Female
  • Hemoglobins / metabolism
  • Humans
  • Leukocyte Count
  • Leukocytosis / blood
  • Leukocytosis / etiology*
  • Leukocytosis / pathology
  • Middle Aged
  • Platelet Count
  • Preoperative Period
  • Prognosis
  • Proportional Hazards Models
  • Thrombocytosis / blood
  • Thrombocytosis / etiology*
  • Thrombocytosis / pathology
  • Young Adult

Substances

  • Hemoglobins