Abnormal preoperative haematological parameters in Endometrial cancer; reflecting tumour aggressiveness or reduced response to radiotherapy?
Background In endometrial cancer (EC), preoperative anaemia, thrombocytosis and leucocytosis appear to be associated with worse prognosis. It remains unclear whether these parameters solely reflect tumour aggressiveness, or also impact response to adjuvant treatment. Therefore, our primary aim is to...
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Taylor & Francis Group
2024-12-01
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| Series: | Journal of Obstetrics and Gynaecology |
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| author | Stephanie W. Vrede Hannah Donkers Casper Reijnen Anke Smits Nicole C.M. Visser Peggy M. Geomini Huy Ngo Dennis van Hamont Brenda M. Pijlman Maria Caroline Vos Marc P.L.M. Snijders Roy Kruitwagen Ruud L.M. Bekkers Khadra Galaal Johanna M.A. Pijnenborg |
| author_facet | Stephanie W. Vrede Hannah Donkers Casper Reijnen Anke Smits Nicole C.M. Visser Peggy M. Geomini Huy Ngo Dennis van Hamont Brenda M. Pijlman Maria Caroline Vos Marc P.L.M. Snijders Roy Kruitwagen Ruud L.M. Bekkers Khadra Galaal Johanna M.A. Pijnenborg |
| author_sort | Stephanie W. Vrede |
| collection | DOAJ |
| description | Background In endometrial cancer (EC), preoperative anaemia, thrombocytosis and leucocytosis appear to be associated with worse prognosis. It remains unclear whether these parameters solely reflect tumour aggressiveness, or also impact response to adjuvant treatment. Therefore, our primary aim is to evaluate the prognostic relevance of anaemia, thrombocytosis and leucocytosis on survival in EC. Secondary, to explore their predictive relevance in response to radiotherapy in EC.Methods A retrospective multicentre cohort study was performed within 10 hospitals. Preoperative haematological parameters were defined as: Anaemia – haemoglobin <7.45 mmol/L (<12 g/Dl), thrombocytosis – platelets >400 × 109 platelets/L, leucocytosis – leukocytes >10 × 109/L. The relationship of haematological parameters with clinicopathological characteristics, ESGO/ESTRO/ESP risk groups and survival were evaluated. Furthermore, the predictive value of haematological parameters was determined on the overall response to adjuvant radiotherapy and for the ESGO/ESTRO/ESP intermediate-risk group solely receiving radiotherapy.Results A total of 894 patients were included with a median follow-up of 4.5 years. Anaemia was present in 103 (11.5%), thrombocytosis in 79 (8.8%) and leucocytosis in 114 (12.7%) patients. The presence of anaemia or thrombocytosis was significantly associated with ESGO/ESTRO/ESP high-risk (respectively, P = 0.002 and P = 0.041). In the entire cohort, anaemia remained independently associated with decreased disease-specific survival (HR 2.31, 95% CI (1.19–4.50), P = 0.013) after adjusting for age, the abnormal haematological parameters and ESGO/ESTRO/ESP risk groups. In patients that were treated with adjuvant radiotherapy (n = 239), anaemia was associated with significant reduced 5-year disease-specific and recurrence-free survival (P = 0.005 and P = 0.025, respectively). In ESGO/ESTRO/ESP intermediate risk patients that received solely vaginal brachytherapy (n = 74), anaemia was associated with reduced disease-specific survival (P = 0.041).Conclusions Current data demonstrate the importance of preoperative anaemia as independent prognostic factor in patients with EC. Moreover, anaemia seems to be associated with reduced response to radiotherapy. Prospective validation in a larger study cohort is needed to verify anaemia as predictive biomarker for radiotherapy. What is already known on this subject? In endometrial cancer, preoperative abnormal haematological parameters like, anaemia, thrombocytosis and leucocytosis appears to be associated with FIGO advanced-stage and unfavourable outcome.What do the results of this study add? It remains unclear whether anaemia, thrombocytosis or leucocytosis solely reflecting worse prognosis by advanced tumour stage, or also impact response to adjuvant treatment. Current data demonstrate that anaemia is independent associated with decreased disease-specific survival and anaemia seems related with reduced response to radiotherapy and in specific to vaginal brachytherapy in ESGO/ESTRO/ESP intermediate risk patients.What are the implications of these findings for clinical practice and/or further research? Specific applied adjuvant treatment is needed if patients with anaemia have a reduced response to radiotherapy in EC. Prospective validation in a larger study cohort is required to verify anaemia as predictive biomarker for radiotherapy and to further evaluate the prognostic/predictive impact of anaemia in addition to the molecular subgroups. |
| format | Article |
| id | doaj-art-47c1e1cca20140df8cdf7eeb83eb6baa |
| institution | Kabale University |
| issn | 0144-3615 1364-6893 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
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| series | Journal of Obstetrics and Gynaecology |
| spelling | doaj-art-47c1e1cca20140df8cdf7eeb83eb6baa2025-01-09T12:13:17ZengTaylor & Francis GroupJournal of Obstetrics and Gynaecology0144-36151364-68932024-12-0144110.1080/01443615.2023.2294332Abnormal preoperative haematological parameters in Endometrial cancer; reflecting tumour aggressiveness or reduced response to radiotherapy?Stephanie W. Vrede0Hannah Donkers1Casper Reijnen2Anke Smits3Nicole C.M. Visser4Peggy M. Geomini5Huy Ngo6Dennis van Hamont7Brenda M. Pijlman8Maria Caroline Vos9Marc P.L.M. Snijders10Roy Kruitwagen11Ruud L.M. Bekkers12Khadra Galaal13Johanna M.A. Pijnenborg14Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the NetherlandsDepartment of Obstetrics and Gynaecology, Royal Cornwall Hospital NHS Trust, Truro, Cornwall, United KingdomDepartment of Radiation Oncology, Radboud University Medical Centre, Nijmegen, the NetherlandsDepartment of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the NetherlandsDepartment of Pathology, Stichting PAMM, Eindhoven, the NetherlandsDepartment of Obstetrics and Gynaecology, Maxima Medical Centre, Veldhoven, the NetherlandsDepartment of Obstetrics and Gynaecology, Elkerliek Hospital, Helmond, the NetherlandsDepartment of Obstetrics and Gynaecology, Amphia Hospital, Breda, the NetherlandsDepartment of Obstetrics and Gynaecology, Jeroen Bosch Hospital, ‘s-Hertogenbosch, the NetherlandsDepartment of Obstetrics and Gynaecology, Elisabeth-Tweesteden Hospital, Tilburg, the NetherlandsDepartment of Obstetrics and Gynaecology, Canisius-Wilhelmina Hospital, Nijmegen, the NetherlandsDepartment of Obstetrics and Gynaecology, Maastricht UMC+, Maastricht, the NetherlandsDepartment of Obstetrics and Gynaecology, Catharina Hospital, Eindhoven, the NetherlandsDepartment of Obstetrics and Gynaecology, Royal Cornwall Hospital NHS Trust, Truro, Cornwall, United KingdomDepartment of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the NetherlandsBackground In endometrial cancer (EC), preoperative anaemia, thrombocytosis and leucocytosis appear to be associated with worse prognosis. It remains unclear whether these parameters solely reflect tumour aggressiveness, or also impact response to adjuvant treatment. Therefore, our primary aim is to evaluate the prognostic relevance of anaemia, thrombocytosis and leucocytosis on survival in EC. Secondary, to explore their predictive relevance in response to radiotherapy in EC.Methods A retrospective multicentre cohort study was performed within 10 hospitals. Preoperative haematological parameters were defined as: Anaemia – haemoglobin <7.45 mmol/L (<12 g/Dl), thrombocytosis – platelets >400 × 109 platelets/L, leucocytosis – leukocytes >10 × 109/L. The relationship of haematological parameters with clinicopathological characteristics, ESGO/ESTRO/ESP risk groups and survival were evaluated. Furthermore, the predictive value of haematological parameters was determined on the overall response to adjuvant radiotherapy and for the ESGO/ESTRO/ESP intermediate-risk group solely receiving radiotherapy.Results A total of 894 patients were included with a median follow-up of 4.5 years. Anaemia was present in 103 (11.5%), thrombocytosis in 79 (8.8%) and leucocytosis in 114 (12.7%) patients. The presence of anaemia or thrombocytosis was significantly associated with ESGO/ESTRO/ESP high-risk (respectively, P = 0.002 and P = 0.041). In the entire cohort, anaemia remained independently associated with decreased disease-specific survival (HR 2.31, 95% CI (1.19–4.50), P = 0.013) after adjusting for age, the abnormal haematological parameters and ESGO/ESTRO/ESP risk groups. In patients that were treated with adjuvant radiotherapy (n = 239), anaemia was associated with significant reduced 5-year disease-specific and recurrence-free survival (P = 0.005 and P = 0.025, respectively). In ESGO/ESTRO/ESP intermediate risk patients that received solely vaginal brachytherapy (n = 74), anaemia was associated with reduced disease-specific survival (P = 0.041).Conclusions Current data demonstrate the importance of preoperative anaemia as independent prognostic factor in patients with EC. Moreover, anaemia seems to be associated with reduced response to radiotherapy. Prospective validation in a larger study cohort is needed to verify anaemia as predictive biomarker for radiotherapy. What is already known on this subject? In endometrial cancer, preoperative abnormal haematological parameters like, anaemia, thrombocytosis and leucocytosis appears to be associated with FIGO advanced-stage and unfavourable outcome.What do the results of this study add? It remains unclear whether anaemia, thrombocytosis or leucocytosis solely reflecting worse prognosis by advanced tumour stage, or also impact response to adjuvant treatment. Current data demonstrate that anaemia is independent associated with decreased disease-specific survival and anaemia seems related with reduced response to radiotherapy and in specific to vaginal brachytherapy in ESGO/ESTRO/ESP intermediate risk patients.What are the implications of these findings for clinical practice and/or further research? Specific applied adjuvant treatment is needed if patients with anaemia have a reduced response to radiotherapy in EC. Prospective validation in a larger study cohort is required to verify anaemia as predictive biomarker for radiotherapy and to further evaluate the prognostic/predictive impact of anaemia in addition to the molecular subgroups.https://www.tandfonline.com/doi/10.1080/01443615.2023.2294332Anaemiaradiotherapyvaginal brachytherapy |
| spellingShingle | Stephanie W. Vrede Hannah Donkers Casper Reijnen Anke Smits Nicole C.M. Visser Peggy M. Geomini Huy Ngo Dennis van Hamont Brenda M. Pijlman Maria Caroline Vos Marc P.L.M. Snijders Roy Kruitwagen Ruud L.M. Bekkers Khadra Galaal Johanna M.A. Pijnenborg Abnormal preoperative haematological parameters in Endometrial cancer; reflecting tumour aggressiveness or reduced response to radiotherapy? Journal of Obstetrics and Gynaecology Anaemia radiotherapy vaginal brachytherapy |
| title | Abnormal preoperative haematological parameters in Endometrial cancer; reflecting tumour aggressiveness or reduced response to radiotherapy? |
| title_full | Abnormal preoperative haematological parameters in Endometrial cancer; reflecting tumour aggressiveness or reduced response to radiotherapy? |
| title_fullStr | Abnormal preoperative haematological parameters in Endometrial cancer; reflecting tumour aggressiveness or reduced response to radiotherapy? |
| title_full_unstemmed | Abnormal preoperative haematological parameters in Endometrial cancer; reflecting tumour aggressiveness or reduced response to radiotherapy? |
| title_short | Abnormal preoperative haematological parameters in Endometrial cancer; reflecting tumour aggressiveness or reduced response to radiotherapy? |
| title_sort | abnormal preoperative haematological parameters in endometrial cancer reflecting tumour aggressiveness or reduced response to radiotherapy |
| topic | Anaemia radiotherapy vaginal brachytherapy |
| url | https://www.tandfonline.com/doi/10.1080/01443615.2023.2294332 |
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