title: Significance of Monocyte Counts at Recurrence on Survival Outcome of Women With Endometrial Cancer.
abstract: Tumor-associated macrophages (TAMs) are known to have adverse effects on the survival of women with endometrial cancer. Because monocytes function as progenitors of macrophages, this study examined the association between monocyte count at the first recurrence/progression of endometrial cancer and survival time after recurrence/progression (SAR).
  
  
  
  This is a retrospective study evaluating 141 consecutive cases of recurrent endometrial cancer after surgical staging (n = 114) and progression after nonsurgical management (n = 27). Complete blood cell counts with cell differentiation at the time of the first recurrence/progression were correlated to SAR.
  
  
  
  Median time of SAR was 7.8 months, and there were 97 (68.8%) patients who died from endometrial cancer with 1-, 2-, and 5-year SAR rates being 51.0%, 32.9%, and 14.2%, respectively. Median monocyte counts at recurrence/progression were 0.5 × 10/L. The strongest correlation to monocyte counts was seen in neutrophil counts (r = 0.57, P < 0.01) followed by platelet counts (r = 0.43, P < 0.01). An elevated monocyte count at recurrence/progression was significantly associated with decreased SAR (hazard ratio per unit, 3.97; 95% confidence interval, 2.00-7.90; P < 0.01). On multivariate analysis controlling for patient demographics, complete blood cell counts, tumor factors, and treatment types for recurrent/progressed disease, higher monocyte counts at recurrence/progression remained an independent predictor for decreased SAR (hazard ratio per unit, 3.12; 95% confidence interval, 1.52-6.67; P < 0.01).
  
  
  
  Our study demonstrated that the increased monocyte counts at recurrence/progression may be a useful biomarker for predicting decreased survival outcome of women with endometrial cancer.
authors.affiliation: *Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California; and †Norris Comprehensive Cancer Center, Los Angeles; and ‡Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Kaiser Permanente, Orange County, CA.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Machida
authors.forename: Madushka Yohan
authors.initials: MY
authors.lastname: De Zoysa
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takiuchi
authors.forename: Marianne S
authors.initials: MS
authors.lastname: Hom
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Tierney
authors.forename: Koji
authors.initials: K
authors.lastname: Matsuo
mesh_terms: D001792:Blood Platelets / Q000473:pathology; D018269:Carcinoma, Endometrioid / Q000097:blood / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008875:Middle Aged; D009000:Monocytes / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology; D010976:Platelet Count; D012189:Retrospective Studies