title: Preoperative anemia, leukocytosis and thrombocytosis identify aggressive endometrial carcinomas.
abstract: OBJECTIVE
  The objective of this study is to investigate preoperative hematological parameters for anemia, leukocytosis and thrombocytosis in relation to established prognostic factors and survival in endometrial cancer.
  
  
  METHODS
  557 patients treated for endometrial carcinoma were prospectively included in a study focusing on the relationship between preoperative hemoglobin, leukocyte and platelet counts, and a panel of clinicopathological characteristics and outcome.
  
  
  RESULTS
  Preoperative anemia was present in 15.8%, leukocytosis in 11.2% and thrombocytosis in 12.1%. Among patients with localized disease (FIGO stage I/II), 18.1% had anemia and/or thrombocytosis at diagnosis. Patients with advanced disease (high FIGO stage and lymph-node metastasis) had significantly lower hemoglobin count, higher leukocyte count and higher platelet count (all p<0.008). Patients with anemia, leukocytosis and thrombocytosis had significantly shorter 5-year disease-specific survival of 61.3%, 66.0% and 61.0% respectively, compared to 87.7%, 86.3% and 87.3% for patients with normal counts (all p<0.001). In multivariate Cox regression analysis, lower hemoglobin counts and higher platelet counts were independently associated with poor outcome adjusted for the standardly applied prognostic markers (p<0.033).
  
  
  CONCLUSIONS
  Preoperative anemia, leukocytosis or thrombocytosis in women with endometrial carcinoma is associated with advanced disease and poor disease-specific survival.
authors.affiliation: Department of Clinical Science, University of Bergen, Haukeland University Hospital, 5021 Bergen, Norway.
authors.forename: Tormund S
authors.initials: TS
authors.lastname: Njølstad
authors.forename: Hilde
authors.initials: H
authors.lastname: Engerud
authors.forename: Henrica M J
authors.initials: HM
authors.lastname: Werner
authors.forename: Helga B
authors.initials: HB
authors.lastname: Salvesen
authors.forename: Jone
authors.initials: J
authors.lastname: Trovik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood / Q000209:etiology* / Q000473:pathology; D015331:Cohort Studies; D016889:Endometrial Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007958:Leukocyte Count; D007964:Leukocytosis / Q000097:blood / Q000209:etiology* / Q000473:pathology; D008875:Middle Aged; D010976:Platelet Count; D057234:Preoperative Period; D011379:Prognosis; D016016:Proportional Hazards Models; D013922:Thrombocytosis / Q000097:blood / Q000209:etiology* / Q000473:pathology; D055815:Young Adult
chemical_list: D006454:Hemoglobins
keywords: Endometrial cancer; Leukocytosis; Preoperative anemia; Prognosis; Thrombocytosis