Elevated white blood cell count at the time of recurrence diagnosis is an indicator of short survival in patients with recurrent cervical cancer.
OBJECTIVE
The aim of this study was to investigate the prognostic significance of elevated white blood cell (WBC) count at the time of the diagnosis of cervical cancer recurrence.


METHODS
The baseline characteristics and outcome data of 219 patients who had a diagnosis of recurrent cervical cancer between April 1996 and September 2010 were collected and reviewed. Survival after recurrence was compared between the leukocytosis group (WBC ≥9000/μL) and the nonleukocytosis group (WBC <9000/μL). A Cox proportional hazards regression model was used to investigate the prognostic significance of elevated WBC count in patients with recurrent cervical cancer.


RESULTS
The patients in the leukocytosis group showed significantly shorter disease-free interval (P = 0.0005) and more frequently had multiple recurrences (P = 0.0101) than those in the nonleukocytosis group. The median survival after recurrence of the patients with elevated WBC count was 9 months, which was significantly shorter than the 21 months observed in the patients without normal WBC count (log rank; P < 0.0001). Multivariate analyses revealed that clinical stage, tumor diameter, histology, an elevated WBC count (≥9000/μL), and an elevated neutrophil count (≥6500/μL) were significant prognostic factors in survival after recurrence.


CONCLUSIONS
The elevated WBC count at the time of the diagnosis of recurrence is an independent prognostic factor in patients with recurrent cervical cancer.
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita,Osaka, Japan. smabuchi@gyne.med.osaka-u.ac.jp
Seiji
S
Mabuchi
Yuri
Y
Matsumoto
Toshimitsu
T
Hamasaki
Mahiru
M
Kawano
Takeshi
T
Hisamatsu
David G
DG
Mutch
Tadashi
T
Kimura
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000175:diagnosis* / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D007962:Leukocytes / Q000473:pathology*; D007964:Leukocytosis / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D015854:Up-Regulation; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000401:mortality* / Q000473:pathology