title: Prognostic impact of hemoglobin levels before and during carboplatin/taxane-based chemotherapy in patients with primary invasive epithelial ovarian cancer.
abstract: BACKGROUND
  Carboplatin/taxane-based chemotherapy is the standard treatment for advanced primary ovarian cancer. Anemia is a frequent side effect of platinum-containing chemotherapy regimens. Furthermore, ovarian cancer is often associated with tumor anemia. The aim of this study was to evaluate the prognostic relevance of the mean hemoglobin level before and during carboplatin/taxane-based chemotherapy.
  
  
  METHODS
  We studied retrospectively 92 patients with primary invasive epithelial ovarian cancer (EOC) receiving carboplatin/taxane-based chemotherapy. Hemoglobin levels were determined before each cycle of therapy. Study objectives were progression-free survival time (PFS) and overall survival time (OS). Univariate analyses and Cox-regression studies were undertaken to evaluate the prognostic impact of hemoglobin levels before and throughout chemotherapy. In addition, sensitivity/specificity analyses and Kaplan-Meier-studies were performed to determine the cut-off level of prognostically relevant hemoglobin levels.
  
  
  RESULTS
  In univariate analysis hemoglobin levels throughout chemotherapy showed prognostic relevance in terms of PFS (p<0.05). Sensitivity/specificity and Kaplan-Meier analyses found a hemoglobin level of 11.2 g/dL to be a prognostically relevant cut-off level in terms of PFS (p<0.05). There was a borderline significance for pretherapeutic hemoglobin levels to influence PFS (p=0.07), with a prognostically relevant cut-off level of 11.6 g/dL (p=0.06).
  
  
  CONCLUSIONS
  Hemoglobin levels before and particularly throughout therapy seem to have prognostic relevance for patients with primary EOC undergoing carboplatin/taxane-based chemotherapy. Further trials are required to confirm these data in a prospective attempt and to evaluate the role of correcting anemia as standard supportive therapy in the treatment of patients with primary EOC.
authors.affiliation: Department of Gynecology and Obstetrics, University of Heidelberg Medical School, Heidelberg, Germany. michael_eichbaum@med.uni-heidelberg.de
authors.forename: Michael H R
authors.initials: MH
authors.lastname: Eichbaum
authors.forename: Luise M E
authors.initials: LM
authors.lastname: Weiss
authors.forename: Thomas
authors.initials: T
authors.lastname: Bruckner
authors.forename: Andreas
authors.initials: A
authors.lastname: Schneeweiss
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Sinn
authors.forename: Gerhard
authors.initials: G
authors.lastname: Gebauer
authors.forename: Nikos
authors.initials: N
authors.lastname: Fersis
authors.forename: Julia
authors.initials: J
authors.lastname: Kussmaul
authors.forename: Christof
authors.initials: C
authors.lastname: Sohn