Prognostic value of baseline lymphocyte count in cervical carcinoma treated with concurrent chemoradiation.
OBJECTIVE
This study examined factors predicting tumor response and progression-free survival in patients with locally advanced cervical carcinoma treated with concurrent chemoradiation (CCRT).


METHODS
Medical records of 143 patients with locally advanced cervical carcinoma (International Federation of Gynecology and Obstetrics Stage IB2 to IVA) treated with CCRT were reviewed. Univariate and multivariate analyses were used to retrospectively evaluate prognostic factors, including baseline lymphocyte count, that affect tumor response and progression-free survival.


RESULTS
Of the variables evaluated, greater baseline lymphocyte count was the factor most predictive of a complete clinical response, followed by smaller tumor size (p = 0.003 and p = 0.007, respectively). Multivariate analysis showed baseline lymphocyte count, which was treated as a continuous variable with every 1 x 10(9) lymphocytes/L, to remain a prognostic factor with an odds ratio of 3.08 (95% confidence interval, 1.31-7.23). In addition, a statistically significant association (p = 0.023) was found between baseline lymphocyte count and progression-free survival, with a hazard ratio of 0.42 (95% confidence interval, 0.20-0.89) in the Cox proportional hazards model.


CONCLUSIONS
Despite the small number of patients and possible biologic variation existing in lymphocyte subset number and activity, these findings highlight the strong prognostic value of baseline lymphocyte count in patients with locally advanced cervical carcinoma treated with CCRT. Therefore, a larger number of patients and analysis of lymphocyte subsets are needed.
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Chel Hun
CH
Choi
Heeseok
H
Kang
Woo Young
WY
Kim
Tae-Joong
TJ
Kim
Jeong-Won
JW
Lee
Seung Jae
SJ
Huh
Je-Ho
JH
Lee
Byoung-Gie
BG
Kim
Duk-Soo
DS
Bae
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000276:immunology / Q000473:pathology / Q000532:radiotherapy; D003131:Combined Modality Therapy / Q000379:methods; D018572:Disease-Free Survival; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008875:Middle Aged; D011379:Prognosis; D012074:Remission Induction; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology / Q000532:radiotherapy*