Pretreatment hemoglobin, platelet count, and prognosis in endometrial carcinoma

We analyzed whether a low preteatment hemoglobin level is a prognostic fact or in endometrial cancer and whether it is associated with thrombocytosis. Two hundred and twelve patients with endometrial cancer treated with surger y were reviewed. Data were analyzed with Pearson's chi-squared test, Fisher 's exact test in contingency tables, the Mann-Whitney LI-test, the Student' s t-test, and Kaplan-Meier estimates. Multivariate analysis was performed w ith the log-rank test and the Cox proportional hazard model. Thirty-nine pa tients (18%) had a pretreatment hemoglobin value of <12.0 g/dL. These 39 pa tients had significantly higher rates of nonendometrioid histology, high-gr ade tumors, myometrial invasion of >50%, adnexal involvement, lymph-vascula r space involvement, and advanced FIGO stage than patients with hemoglobin greater than or equal to 12.0 g/dL. The rate of thrombocytosis was signific antly higher in patients with a low hemoglobin level (36% vs. 8%, P < 0.01) . The overall 5-year survival rate of patients with low pretreatment hemogl obin was 59% compared with 89% for those with hemoglobin <greater than or e qual to>12 g/dL (P < 0.01). In the multivariate analysis age, thrombocytosi s, nonendometrioid histology, high-grade histology, and advanced FIGO stage were significantly associated with a poor prognosis whereas adnexal involv ement, lymph-vascular space involvement, low hemoglobin and myometrial inva sion were not. These data indicate that low pretreatment hemoglobin is a pr ognostic factor in patients with endometrial cancer and that it is associat ed with thrombocytosis. Low hemoglobin was strongly associated with other u nfavorable prognostic factors so that it was significant in the univariate but not the multivariate analysis.