Prognostic Significance of Preoperative Anemia, Leukocytosis and Thrombocytosis in Chinese Women with Epithelial Ovarian Cancer


Malignant tumors are often accompanied by increased risk of hematological abnormalities. However, fewstudies have reported any prognostic impact of preoperative thrombocytosis, leukocytosis and anemia in epitheliaovarian cancer (EOC). This study aimed to investigate preoperative hematological parameters for anemia,leukocytosis and thombocytosis in relation to established prognostic factors and survival in EOC cases. A totalof 816 Chinese women treated for EOC were retrospectively included in the study focusing on the relationshipbetween preoperative hemoglobin, leukocyte and platelet counts, and a panel of clinicopathologic characteristicsand outcome. Preoperative anemia was present in 13.4%, leukocytosis in 16.7% and thrombocytosis in 22.8% .Additionally, EOC patients with low differentiation grade, advanced stage, lymph node (LN) metastasis, residualdisease ≥ 1cm, ascites volume >1,000ml, serum cancer antigen 125 (CA125) >675U/ml, and disease recurrencehad the higher prevalence of preoperative anemia, leukocytosis and thrombocytosis (all p<0.05). Moreover,EOC patients with older age or postmenopausal EOC patients had the higher prevalence of thrombocytosis(28.7% vs 17.3% or 26.0% vs 17.7%). Furthermore, in a Cox proportional hazard model, thrombocytosis wasan independent factor for progression-free survival (PFS) and overall survival (OS) (p<0.001). Conclusively,preoperative anemia, leukocytosis or thrombocytosis in EOC patients is closely associated with more malignantdisease phenotype and poorer prognosis. Significantly, thrombocytosis may independently predict the diseasespecificsurvival for EOC patients.