Abstract
The aim of this study was to investigate the association between preoperative leukocyte and platelet counts and the stage of the disease in patients with endometrial cancer. Data for 100 patients undergoing total abdominal hysterectomy and bilateral salpingoophorectomy for benign uterine diseases and 177 patients surgically staged for endometrial cancer at Ondokuz Mayis University, Department of Gynecology and Obstetrics between 2005 and 2013, with preoperative complete blood count in the week prior to surgery including WBC, platelet count, pathologic evaluation for both benign and malign endometrium lesions, tumor stage and presence of lymphovascular space invasion (LVI), were retrospectively analyzed. The preoperative leukocyte count was significantly higher in patients with endometrial cancer when compared to the patients with benign diseases. However, there were no significant differences in platelet counts between the groups. Patients with advanced stage endometrial cancer had higher preoperative leukocyte counts when compared to the early stage disease whereas there was no difference in platelet count. Multivariate regression analysis identified preoperative leukocytosis as an independent prognostic factor for endometrial cancer. The optimal cut-off point for WBC was calculated as 10,500 to differentiate stage 1-2-3 and 4 with 88.9% sensitivity and 86.3% specificity (AUC: 0.901, 95% CI: 0.829-0.973, p<0.001, PPV: 25.8%, NPV: 99.3%). Preoperative leukocytosis is independently associated with advanced endometrial cancer.
Highlights
Materials and Methods: Data for 100 patients undergoing total abdominal hysterectomy and bilateral salpingoophorectomy for benign uterine diseases and 177 patients surgically staged for endometrial cancer at Ondokuz Mayis University, Department of Gynecology and Obstetrics between 2005 and 2013, with preoperative complete blood count in the week prior to surgery including WBC, platelet count, pathologic evaluation for both benign and malign endometrium lesions, tumor stage and presence of lymphovascular space invasion (LVI), were retrospectively analyzed
Staging surgery which consists of peritoneal washing, total hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node (PLN) dissection with or without paraaortic lymph node (PALN) dissection remains the cornerstone in primary treatment for endometrial cancer (Pecorelli, 2009)
The study included the patients surgically staged for endometrial cancer according to FIGO 2009 guidelines which consisted of peritoneal cytology, total abdominal hysterectomy, bilateral salpingo-oophorectomy, systemic pelvic and para-aortic lymphadenectomy (Pecorelli, 2009), and the patients underwent total abdominal or vaginal hysterectomy for benign uterine diseases such as endometrial polip, fibroid, uterine prolapsus at Ondokuz Mayis University, Department of Gynecology and Obstetrics between 2005 and 2013
Summary
Endometrial cancer is the most common gynecologic malignancy in developed countries (Ferlay et al, 2012). The aim of this study was to evaluate the significance of preoperative leukocytosis and thrombocytosis among patients with endometrial cancer. Patients’ preoperative and postoperative data, including demographic features, complete blood count in the week prior to surgery with differentials including WBC, platelet count, histopathologic evaluations for both benign and malign endometrium lesions, grade of endometrial cancer, tumor stage, tumor size, presence of lymphovascular space invasion (LVI) and overall survival were retrospectively analyzed. To determinate whether preoperative WBC and PLT were 118 (66.7%) patients with stage I, 24 (13.6%) cases were significant to discriminate the groups in terms of with stage II, 26 (14.7%) patients with stage III and only clinical features, ROC analysis was applied and area nine (5.1%) cases with advanced stage IV.
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