title: Pre-treatment white blood cell subtypes as prognostic indicators in ovarian cancer.
abstract: OBJECTIVE
  Inflammatory cells can both suppress and stimulate tumour growth and their influence on clinical outcome in cancer patients has been studied in various cancer types. Here we have investigated their influence on outcome in primary epithelial ovarian cancer.
  
  
  METHODS
  Serum white blood cell numbers according to subtype were recorded prior to treatment in 136 patients with primary epithelial ovarian cancer. Their correlation with overall survival and disease-free survival was analysed using both univariate and multivariate analysis adjusting for the known prognostic factors (age, stage and debulking status).
  
  
  RESULTS
  Multivariate analysis demonstrated that a lower lymphocyte fraction of total white blood cells was significantly associated with mortality (p<0.01). On univariate analysis (p=0.0027, HR=1.15), and multivariate analysis of those patients who were optimally debulked (p=0.036, HR=1.17), a higher monocyte count was significantly associated with recurrence. On multivariate analysis amongst those who were suboptimally debulked, a higher eosinophil count was predictive of both recurrence (p=0.0037, HR=1.77) and mortality (p=0.033, HR=1.73).
  
  
  CONCLUSIONS
  High monocyte counts amongst those who were optimally debulked independently predict adverse outcome in primary epithelial ovarian cancer.
authors.affiliation: Department of Gynaecological Oncology, Royal Marsden Hospital, London, UK. sam@bishara.freeserve.co.uk
authors.forename: S
authors.initials: S
authors.lastname: Bishara
authors.forename: M
authors.initials: M
authors.lastname: Griffin
authors.forename: A
authors.initials: A
authors.lastname: Cargill
authors.forename: A
authors.initials: A
authors.lastname: Bali
authors.forename: M E
authors.initials: ME
authors.lastname: Gore
authors.forename: S B
authors.initials: SB
authors.lastname: Kaye
authors.forename: J H
authors.initials: JH
authors.lastname: Shepherd
authors.forename: P O
authors.initials: PO
authors.lastname: Van Trappen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008875:Middle Aged; D009000:Monocytes; D010051:Ovarian Neoplasms / Q000276:immunology* / Q000601:surgery; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome