The Prognostic Model of Pre-Treatment Complete Blood Count (CBC) for Recurrence in Early Cervical Cancer

Joseph J Noh,Yun Hwan Kim,Chulmin Lee,Seok Ju Seong,Chel Hun Choi,Eun Seop Song,Myong Cheol Lim,Jong-Min Lee,Moon-Hong Kim,Dong Hoon Suh

doi:10.3390/jcm9092960

Abstract

The aim of the present study was to investigate the prognostic role of the pre-treatment complete blood count (CBC) profile as a predictive marker of survival, recurrence, and death in early stage squamous cell carcinoma and adenocarcinoma of the cervix. The pre-treatment CBC profiles of the patients from nine tertiary medical centers in South Korea who were treated surgically for early stage cervical cancer were reviewed. Statistical models by the Akaike’s information criterion (AIC) were developed using CBC profiles to calculate individuals’ risk scores for clinical outcomes. A total of 1443 patients were included in the study and the median follow-up was 63.7 months with a range of 3–183 months. Univariate analyses identified the components of CBC that were significantly related to clinical outcomes including white blood cell (WBC), hemoglobin, neutrophil, and platelet levels. The models developed using CBC profiles and the conventional clinical predictive factors provided individuals’ risk scores that were significantly better in predicting clinical outcomes than the models using the conventional clinical predictive factors alone. Pre-treatment CBC profiles including WBC, hemoglobin, neutrophil, lymphocyte, and platelet levels were found to be a potential biomarker for survival prognosis in early cervical cancer.

Highlights

Cervical cancer is the second most common malignancy in females worldwide and the leading cause of cancer-related deaths among women, especially in developing countries
We evaluated overall survival, lymphatic recurrence, and hematogenous recurrence separately because each often requires different treatment modalities
Univariate analysis indicated that hemoglobin and platelet levels were related to overall recurrence (DFS) (Supplementary Table S1)

Summary

Introduction

Cervical cancer is the second most common malignancy in females worldwide and the leading cause of cancer-related deaths among women, especially in developing countries. A 10–20% recurrence rate has been reported following primary surgery or radiotherapy in women with stage IB–IIA cervical cancer with no evidence of lymph node involvement; while up to 70% of patients with nodal metastases were reported to relapse [3,4,5,6]. The FIGO (International Federation of Gynecology and Obstetrics) staging system is one of the most commonly used predictors for survivals, and often determines patients’ treatment plans in the current clinical settings [7]. Because it is based on clinical evaluation of the anatomic extent; the correlation between the FIGO staging and final histopathologic classification is not always accurate. It is necessary to improve the FIGO staging system for more accurate prognosis in cervical cancer, thereby, allowing beneficial individualized treatment

Objectives

Methods

Results