title: Prognostic significance of hemoglobin levels in patients with primary epithelial ovarian carcinoma undergoing platinum-based chemotherapy.
abstract: The aim of this study was to evaluate the prognostic impact of hemoglobin (Hb) levels before and throughout the course of platinum-based chemotherapy in patients with primary epithelial ovarian cancer (EOC). Medical records of patients who had undergone initial surgery followed by platinum-based chemotherapy for EOC were retrospectively studied. Univariate and Cox-regression models were used to evaluate the prognostic impact of various factors including Hb levels before and throughout chemotherapy in terms of overall survival. Additionally, sensitivity/specificity were calculated using receiver operating curves (ROCs) and Kaplan-Meier studies were used to determine optimal cut-off levels. The median duration of follow-up was 37.0 months. Degree of anemia before starting chemotherapy was significantly related to overall survival (p = 0.001), but the Hb level throughout chemotherapy demonstrated only a borderline relationship (p = 0.062). Only residual tumor after surgery and degree of anemia before starting chemotherapy proved to be independent prognostic factors (p = 0.013 and 0.015, respectively). With sensitivity/specificity and Kaplan-Meier analyses, a Hb level before starting chemotherapy of less than 10.5 g/dl was related to shorter overall survival (p = 0.002). In conclusion, pre-chemotherapy Hb level has a prognostic impact on overall survival in patients with EOC candidate to first-line platinum-based chemotherapy. However, the significance of decreased Hb levels during chemotherapy needs to be clarified in further prospective studies to determine optimal Hb levels for achieving a favorable outcome.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Khemmawan
authors.initials: K
authors.lastname: Pongsanon
authors.forename: Mongkol
authors.initials: M
authors.lastname: Benjapibal
authors.forename: Irene
authors.initials: I
authors.lastname: Ruengkhachorn
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D000077216:Carcinoma, Ovarian Epithelial; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood* / Q000188:drug therapy* / Q000601:surgery; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D010051:Ovarian Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000601:surgery; D011379:Prognosis; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D006454:Hemoglobins; D009944:Organoplatinum Compounds