Higher Hemoglobin Values Research Articles

Factors associated with iron deficiency anemia in Brazilian preschool children

To examine the determining factors of anemia and iron deficiency in children attending two day care centers in the town of Pontal, southeast of Brazil. Cross-sectional study was conducted in 192 children aged 12 to 72 months. Personal data (age, sex, use of medicinal iron supplements, duration of breast-feeding, type of delivery, prenatal care, weight, and height), and socioeconomic data (number of co-inhabitants, parental schooling, and per capita family income) were obtained and evaluated together with hemoglobin, serum transferrin receptor, ferritin, and iron deficiency anemia. Age was the variable that most affected iron nutritional status, with higher hemoglobin values, lower transferrin receptor concentrations, higher ferritin values and lower iron deficiency anemia being detected with increasing age. The other studied variables did not show any correlation with iron nutritional status. The obtained data suggest that control strategies for this preschool population should be especially directed at younger children.

High maternal hemoglobin and ferritin values as risk factors for gestational diabetes

A number of studies have linked high maternal serum hemoglobin (Hb) levels in pregnancy with increased incidence of adverse pregnancy outcomes such as low birth weight and small-for-gestational-age newborns pre-term births increased perinatal mortality and pre-eclampsia. Lao et al. Identified high maternal hemoglobin at the initial prenatal visit as a risk factor for gestational diabetes mellitus (GDM). This protective study was conducted on 253 non-diabetic Turkish women with singleton pregnancies whose serum Hb level and mean corpuscular volume (MCV) at the initial visit were > 10 g/dl or > 80 fl respectively. The exclusion criteria were first prenatal visit later than 14 weeks of gestation; pre-existing anemia or hemoglobinopathy chronic disease; such as diabetes mellitus renal or gastrointestinal disorder hypo- or hyper-thyroidism GDM diagnosed before 28 weeks gestation. Values signifying the 50th percentile for Hb (12.2 g/dl) and ferritin (Fe) (19.7 µg/l) were established based on these data and two sets of groups were formed based on the initial-visit-findings (Hb above and below the 50th percentile; Fe above and below the 50th percentile). The pairs of groups were compared with respect to maternal pregnancy and infant characteristics and incidence of GDM. At the first trimester prenatal visit; a blood sample from each subject was analyzed for complete blood count MCV fasting serum glucose level and serum levels of Fe vitamin B12 folic acid and insulin. Insulin sensitivity was calculated using the HOMA index. [(Formula: fasting glucose (mmol/l) X fasting insulin (µunits/ml)/22.5]. All women were screened for GDM between 24 and 28 weeks of gestation with a 50-g oral glucose any subject with serum glucose level > 135 mg is subjected to a 3-h 100-g load OGTT. All the OGTT results at 24-28 weeks gestation were interpreted according to the criteria of Carpenter and Coustan. (excerpt)

Pharmacokinetic-pharmacodynamic modelling of recombinant human erythropoietin in athletes : a population approach.

To develop a pharmacokinetic model able to take into account the negative feedback loop of endogenous erythropoietin production observed after repeated administration of recombinant human erythropoietin (rHuEPO), and to propose a pharmacokinetic-pharmacodynamic model capable of assessing and quantifying the relationship between changes in: (i) serum soluble transferrin receptor (sTfR) levels, (ii) reticulocyte haematocrit (RetHct), and (iii) percentage macrocytes (%Macro) secondary to repeated administration of rHuEPO. Eighteen trained athletes (three females and 15 males) participated in this study. They received subcutaneous injections of rHuEPO-α 50 U/kg bodyweight for 26 days (days 1, 3, 5, 9, 10, 12, 15, 17, 19, 22, 24 and 26) with iron supplementation. Venous blood samples were collected before, during and after rHuEPO treatment for determination of serum erythropoietin concentrations, haematological parameters (RetHct, %Macro) and sTfR levels. Population pharmacokinetic-pharmacodynamic calculations were performed using NONMEM® software. The serum erythropoietin concentration-time profile was compatible with a one-compartment open model and first-order input rate. The mean half-lives calculated from the first and the terminal log-linear parts of the curves were 5.2 and 35.8 hours, respectively. After subcutaneous administration of rHuEPO, the terminal part of the curve should correspond to the absorption rather than the elimination phase ('flip-flop' phenomenon). The total clearance divided by bio-availability was 4.33 L/h. The pharmacodynamic relationship based on a sigmoid E(max) model can be reasonably used to relate changes observed in haematological and biochemical markers after rHuEPO administration to changes in serum erythropoietin concentrations. rHuEPO induces a delayed increase in sTfR levels, RetHct and %Macro. The half-life (t1/2) k(0) (equilibration delay) values were 10.2 days for sTfR, 2 days for RetHct and 10.2 days for %Macro. The pharmaco-kinetic-pharmacodynamic approach developed in this study allowed below-base-line decreases in RetHct levels (i.e. from days 10-26 after the end of rHuEPO treatment) to be taken into account. A negative-feedback loop of red blood cell production further to high haemoglobin and haematocrit values could explain this decrease. The approach described here may provide an additional tool in the war against drug abuse by athletes; indeed, the model could be useful for simulating pharmacokinetic-pharmacodynamic relationships according to different rHuEPO dosage schedules.

Lung volume, chest size, and hematological variation in low-, medium-, and high-altitude central Asian populations.

To evaluate adaptive responses to high-altitude environment, we examined three groups of healthy adult males from Central Asia: 94 high-altitude (HA) Kirghiz subjects (3,200 m above sea level); 114 middle-altitude (MA) Kazakh subjects (2,100 m), and 90 low-altitude (LA) Kirghiz subjects (900 m). Data on chest size (chest perimeter and chest diameter), lung volume (forced expiratory volume (FEV) and forced expiratory volume in 1 sec (FEV1)), and hematological parameters (hemoglobin, erythrocytes, hematocrit, and SaO(2)) are discussed. The results show that 1) chest shape is less flat in the samples living at higher altitude. In the HA sample, chest perimeter is lower but chest excursion is high. 2) In the highlanders, forced vital capacity (FVC) and FEV1 are no higher than in the other samples, even when corrected for stature and body weight. The negative correlation between FVC-FEV1 and age decreases with increasing altitude. 3) The HA and MA samples have higher values of hemoglobin, erythrocytes, and hematocrit. The HA sample has lower SaO(2) and higher arterial oxygen content than the LA sample. No association between hematocrit and age was detected in the four samples. The results indicate that the high-altitude Kirghiz present features of developmental acclimatization to hypobaric hypoxia which are also strongly influenced by other major high-altitude environmental stresses.

A positive relation between high hemoglobin values and the risk of ischemic stroke. Progetto 3A Investigators.

We examined the relationship between the hemoglobin concentration and the risk of ischemic stroke using data from a hospital-based case-control study. A total of 143 patients (age 30-69 years) with a diagnosis of cerebral infarction confirmed by computerized tomography scan and 143 age- and sex-matched controls entered the study. Hemoglobin was higher in the patients with stroke (14.2 +/- 1.6 g/l, mean +/- SD) than in controls (13.7 +/- 1.6 g/l; p < 0.05). Compared with subjects with hemoglobin levels of less than 13 g/l (reference category), the relative risk of ischemic stroke, after allowance for potential risk factors, was 2.0 (95% CI 0.8-4.9) for the 13-13.9 g/l quartile, 2.8 (95% CI 1.2-6.5) for the 14-14.9 g/l quartile, and 3.2 (95% CI 1.4-7.4) for the 14 + g/l quartile (chi 2 for linear trend 7.27, p < 0.01). We conclude that the hemoglobin concentration may be an indicator of risk for ischemic stroke.

Premature infants require additional folate and vitamin B-12 to reduce the severity of the anemia of prematurity

One hundred eighty-four premature infants, < 1800 g at birth and < 36 wk gestation, were entered into a study investigating the role of additional folate and vitamin B-12 supplementation of the anemia of prematurity. All patients initially received vitamin E and iron in accordance with accepted standards. Patients were randomly assigned to four groups to receive orally 0.1 mg folate/d for 4 mo, 100 micrograms vitamin B-12 intramuscularly monthly for 4 mo, both supplements, or neither. All other activities including parenteral nutrition were carried out according to established practices, irrespective of study group. By 10-12 wk, infants treated with vitamin B-12 alone or combined with folate had higher hemoglobin values than the untreated (P < 0.0005) or solely folate-treated (P < 0.01) groups. These findings held true irrespective of wide variations in treatment and feeding practices. The only uncontrolled hematologic nutritional factor, selenium, showed a similar pattern of decline for 10-12 wk in all study patients, whether or not they received additional vitamin supplements.

Acute multiorgan failure syndrome: A potentially catastrophic complication of severe sickle cell pain episodes

The purpose of this report is to characterize the acute multiorgan failure syndrome that complicates some episodes of sickle pain. A retrospective chart review was used to identify episodes of sickle pain complicated by the acute failure of at least two of three organs: lung, liver, or kidney. The defining criteria of organ failure were established, and the clinical characteristics, laboratory values, treatment methods, and outcomes were noted in episodes that met the criteria. Seventeen episodes of acute multiorgan failure were identified in 14 patients, 10 with sickle cell anemia and 4 with hemoglobin SC disease. Most episodes occurred during a pain event that was unusually severe for the patient. The onset of organ failure was associated with fever, rapid fall in hemoglobin level and platelet count, nonfocal encephalopathy, and rhabdomyolysis. Bacterial cultures were negative in all but four episodes. Aggressive transfusion therapy was associated with survival and with rapid recovery of organ function in all but one episode. The syndrome developed in patients who had previously exhibited relatively mild disease with little evidence of chronic organ damage and relatively high hemoglobin values in steady state. Acute multiorgan failure syndrome is a severe, life-threatening complication of pain episodes in patients with otherwise mild sickle cell disease. The syndrome appears to be reversed with prompt, aggressive transfusion therapy. High baseline hemoglobin levels may represent a predisposing factor.

Subcutaneous Recombinant Human Erythropoietin and Autologous Blood Donation Before Coronary Artery Bypass Surgery

Conventional therapies with recombinant human erythropoietin (rHuEPO) to sustain preoperative autologous blood collection entail high doses of the drug at short intervals. To evaluate the efficacy of a single weekly dose of rHuEPO for autologous blood collection, we randomly assigned 24 male patients scheduled for coronary artery bypass surgery to receive 400 IU/kg rHuEPO subcutaneously once a week or iron only. Patients were examined weekly and a total of up to 4 units of autologous blood were obtained if the hemoglobin level exceeded 12 g/dL. Patients receiving rHuEPO had consistently higher hemoglobin values than those receiving iron only (P < 0.001). Consequently, more autologous red cells were obtained from this group (776 +/- 49 mL vs 682 +/- 91 mL; P < 0.05). One patient receiving rHuEPO and eight in the control group required homologous blood at surgery (P < 0.01). These results suggest that 400 IU/kg rHuEPO administered subcutaneously once a week efficiently stimulates erythropoiesis and compensates the hemoglobin decrease after autologous blood donation.

Clinical characteristics and treatment outcome of children with acute lymphocytic leukemia and down's syndrome. A pediatric oncology group study

Of 2947 children with acute lymphocytic leukemia (ALL), treated during three consecutive studies of the Pediatric Oncology Group (1974-1986), 52 (1.8%) had Down's Syndrome (DS). Comparison of clinical and laboratory characteristics showed no significant differences in leukocyte count, racial distribution, sex ratio, platelet count, incidence of mediastinal mass, lymphadenopathy or hepatosplenomegaly, or percentage of blood or bone marrow blasts for children with ALL with or without Down's Syndrome (DS-ALL or NDS-ALL, respectively). However, children with DS-ALL were slightly older at the time of presentation and had higher hemoglobin values. The relative frequency of each major immunophenotype (early pre-B, pre-B, T, or B) was also comparable for patients with or without DS. For this report, treatment regimens were categorized as either conventional (no consolidation therapy) or intensive. Cox regression analysis revealed that the presence of DS, a higher leukocyte count, black race, or age older than 10 years was independently associated with a poorer event-free survival (EFS) for children treated with conventional chemotherapy. However, for the cohort of children who received intensive chemotherapy, DS was no longer an independent risk factor. In fact, event-free survival (EFS) was markedly improved to a level comparable with that observed in the children diagnosed as having NDS-ALL. On the other hand, serious toxicity, requiring interruption of treatment, was significantly more frequent in the intensively treated children with DS compared with similarly treated patients with NDS-ALL, although deaths resulting from toxicity occurred infrequently.

Clinical and biochemical heterogeneity of alcoholism: The role of family history and alexithymia

Of 100 male patients with alcohol dependence, clinical and biochemical data were analysed in relation to family history of alcoholism and alexithymic personality traits. Family history was found in 38 patients and alexithymic personality traits in 79. No relationship was established between these two factors. In patients with a family history alcoholism began at a younger age with more severe clinical symptoms than in the remaining subjects. Patients with alexithymia had lower intensity of psychopathology but higher frequency of concomitant hypertension. Patients with family history had higher leukocyte counts and lower alcohol-induced elevations of liver enzymes and plasma lipids. In patients with alexithymia, higher values of hemoglobin and hematocrit were found. The results suggest that two predisposing factors to alcohol dependence such as family history of alcoholism and alexithymic personality determine the different clinical and biochemical features of the disease.

Silicon facilitation of copper utilization in the rat

An eight-week, 2 × 4 factorial rat experiment using two levels of dietary copper and four levels of dietary silicon was conducted to further delineate a previously observed silicon-copper interaction in which silicon appears to mimic copper in its effect on the composition of the aorta. Dietary copper concentrations were 1.4 (deficient) and 5.4 (adequate) mg/kg diet, and silicon concentrations were 5, 135, 270, and 540 mg/kg diet. Compared with the lowest level of silicon and copper, weight gains were 15.5% higher for rats fed 540 mg silicon/kg diet and 14.3% higher for those fed 5.4 mg copper/kg diet. The growth-promoting effects of silicon and copper were additive. Evidence that silicon elevated the copper status of copper-deficient rats includes an increase in packed-cell volume by 540 mg silicon/kg diet in the otherwise packed-cell volume-depressed, copper-deficient rats, accompanied by a trend toward higher hemoglobin values and lower relative heart weights. In the copper-adequate rats, evidence that 540 mg silicon/kg diet elevated their copper status includes a two-fold increase in the blood-plasma copper concentration, a three-fold increase in ceruloplasmin activity, and an increase in cardiac, renal, and hepatic copper concentrations. In addition, 540 mg silicon/kg diet resulted in higher aortic dry mass and aortic elastin content in both copper-deficient and copper-adequate rats. While dietary silicon concentrations of 135, 270, and 540 mg/kg diet were all effective in increasing aortic elastin in the copper-adequate rats, only 540 mg silicon/kg diet increased aortic elastin in the copper-deficient rats. These data indicate that some of the metabolic effects attributed to silicon may be manifested through a silicon-facilitated increase in copper utilization.

Haematologic parameters and pregnancy outcome A prospective cohort study in the third trimester

The relationship between haematologic parameters and pregnancy outcome was investigated in a prospective study, taking important covariates into consideration. A questionnaire asking information about smoking, alcohol consumption and iron intake was completed by a consecutive series of 796 ambulatory singleton pregnant women at 31–32 weeks of gestation. Subsequently, haematologic parameters were measured. After delivery, birth weight, gestation length and blood pressure values during pregnancy were abstracted from the obstetricians' records. Low birth weight (< 2.500 g) and preterm birth (< 37 weeks), were significantly more frequently seen in women with high haemoglobin (⩾ 8.0 mmol/1) or high haematocrit (⩾ 38%) values, with Mantel-Haenszel odds ratios varying from 2.4 to 4.2. Also a high erythrocyte count (⩾4.5/pl) was correlated with low birth weight, while for mean corpuscular volume (MCV) no such relationships were found. Pregnancy induced hypertension was positively associated with haemoglobin, haematocrit and erythrocyte count, but could not fully explain the relationships between these parameters and adverse outcomes. Using multiple logistic regression with low birth weight and/or preterm birth as the dependent variable, the effect of haematocrit still was demonstrable after controlling for smoking, hypertension, parity, alcohol consumption and iron intake. These results are in agreement with the hypothesis that a higher blood viscosity is a risk factor for suboptimal placenta-perfusion.

Haematologic parameters as risk factors for cardiac infarction, in an occupational health care setting

It is still controversial, whether moderately high haematocrit (Ht) and haemoglobin (Hb) values are risk factors for coronary heart disease. Using the computerized data-system of the Periodical Medical Examination (PME) of Phillips' International Electrical Company, a- case-control study was carried out. Cases were male workers ( n = 104, from 50 to 60 years of age) who had suffered a first, non-fatal myocardial infarction, and who had had a PME prior (on the average 16 months) to the occurrence of infarction. For each case two age-matched healthy controls were selected from the PME-attendancy list (=208). For each subject information was abstracted from the PME-records about haematologic parameters and covariates (smoking, cholesterol, blood pressure, pulse-rate, weight, height, FEV 5 consumption of antihypertensive agents). After dichotomizing the haematocrit and haemoglobin values at their whole sample means (0.461/1 and 9.7 mmol/l respectively) in “low” (lower than or equal to the mean) and “high” (greater than the mean), crude odds-ratio's of 2.7 (95% Cl: 1.6-4.6) and 2.1 (95% CI: 1.2–3.6) were found for Ht and Hb respectively, when comparing “high” with “low” levels. The associations between Ht and Hb, and the occurrence of myocardial infarction were still present after controlling for covariates using multiple logistic regression models, entering the continuous variables with their exact values. After adjustment, mean corpuscular volume (MCV) also appeared to be correlated with infarction. Our results confirm the hypothesis that moderately high haematocrit and—to a lesser extent—haemoglobin and MCV-values are risk factors for the occurrence of myocardial infarction.

Circulatory manifestations and risk factors in patients with acute cerebrovascular disease and in matched controls.

The occurrence of various circulatory manifestations and risk factors was evaluated in a consecutive series of 209 patients admitted for acute cerebrovascular disease (CVD) and 209 control patients admitted for acute surgical disorders. Old and recent myocardial infarction, atrial fibrillation, congestive heart failure and reduced arterial blood pressure in the big toe were all much more frequently noted in CVD patients than in their matched controls. Hypertension, diabetes mellitus, overweight, high haemoglobin values, were also overrepresented in the CVD patients. Male CVD patients had a higher alcohol consumption than their controls. These findings implicate that CVD in old age is strongly related to both hypertension and a generalized atherosclerosis. The heavy accumulation of primary risk factors, many of which are considered to be primarily associated with atherosclerosis among elderly stroke victims, may indicate their contribution to a progressive atherosclerotic process still in operation.

Hematologic and enzymatic analysis of Ctenopharyngodon idella × Hypophthalmichthys nobilis F 1 hybrids

1. 1. Erythrocyte counts, hemoglobin concentrations and hematocrit values were determined for diploid and triploid Ctenopharyngodon idella × Hypophthalmichthys nobilis hybrids and the parental species. 2. 2. Comparisons of diploid and triploid hybrids with the parental species revealed low erythrocyte counts for triploids, high mean corpuscular hemoglobin values for triploids, elevated hematocrits for diploids and triploids and similar hemoglobin concentrations for all fish. 3. 3. Alkaline phosphatase, aldolase, and lactate dehydrogenase specific activities were determined spectrophotometrically. Levels of specific activity of these enzymes in the hybrids were consistently elevated above that of the parental species. These higher levels of enzyme activities in hybrids were probably the result of a breakdown in gene regulation.

Hematological and clinicochemical values for free-ranging pronghorn fawns.

From 1973 to 1975, inclusive, blood from 253 free-ranging pronghorn (Antilocapra americana) neonates in southeastern Alberta was obtained for hematological and clinicochemical determinations. Mean erythrocyte, hematocrit, hemoglobin, and erythrocyte sedimentation rate values were 9.68 × 106/mm3, 39.7%, 14.6 g/dL, and 21.5 mm/24 h, respectively. Mean leukocyte number in fawns was 3.97 × 103/mm3 of which 62.9% were neutrophils. The high erythrocyte, hematocrit, and hemoglobin values may be a significant adaptive characteristic of pronghorn fawns. Mean clinicochemical values for pronghorn neonates included the following: calcium 12.4 mg/dL, magnesium 2.2 mg/dL, phosphorus 10.0 mg/dL, sodium 145.2 mequiv./L, potassium 6.23 mequiv./L, cholesterol 67.4 mg/dL, glucose 203.5 mg/dL, and creatinine 2.37 mg/dL. With respect to serum enzymes, mean values for glutamic-oxaloacetic transaminase (EC 2.6.1.1), glutamic-pyruvic transaminase (EC 2.6.1.2). creatine phosphokinase (EC 2.7.3.2), and alkaline phosphatase (EC 3.1.3.1) were 106.48 Reitman–Frankel units (R.F.u.)/mL, 2.0 R.F.u./mL, 40.08 International Units (IU)/dL, and 29.64 King–Armstrong units (K.A.u.)/mL, respectively. The mean blood urea nitrogen value was 21.32 mg/dL and total protein value was 4.78 g/dL; the mean albumin:globulin ratio was 1.01. Significant variation of blood values was associated with year of sampling, number of fawns per doe, and sex of fawns. Many blood values were correlated significantly with physical and physiological characteristics of fawns and with environmental temperature and wind speed.

The oxyhemoglobin dissociation curve in type A and type B COPD.

Patients with chronic obstructive pulmonary disease (COPD) have been clinically separated into Type A and Type B COPD. Type A patients are characterized by the presence of anatomical emphysema or an increased total lung capacity, low sputum production, late onset of cough, rare hypercapnia, rare cor pulmonale and absent polycythemia. In contrast, Type B patients are characterized by roentgenographic evidence of chronic inflammation or smaller total lung capacity, significant sputum production, frequent hypercapnia with cor pulmonale and the presence of polycythemia. We studied whole blood oxygen transport (P50, 2,3-DPG, and ATP) in 11 Type A patients and 13 Type B patients. Whole blood oxygen transport was not different in the two groups of patients. Type A patients with higher hemoglobin values had a lower 2,3-DPG. Type A patients with a higher hemoglobin value also had a higher ATP level. In all patients, Type A and Type B, 2,3-DPG was inversely related to hemoglobin concentration. Despite other distinguishing clinical and laboratory characteristics, whole blood oxygen transport was not different in Type A and Type B patients.

Effects of Aureo-S-700R on sporulation, viability and infectivity of ovine coccidial oocysts

Sporulation rates of normal oocysts and oocysts isolated from lambs infected with coccidia and fed Aureo-S-700R for 25 days were studied at different temperatures. The viability and infectivity of the latter were also investigated. Temperatures of 5 and 10 degrees C inhibited sporulation of oocysts, but when the same oocysts were subsequently incubated at 25 degrees C, they sporulated. At 35 and 40 degrees C, sporulation was initially fast, but death and degeneration of oocysts occurred at these temperatures after 3 days. Normal oocysts sporulated faster and in greater numbers than oocysts isolated from medicated lambs; both kinds of oocysts sporulated best between 20 and 25 degrees C. Lambs inoculated with oocysts from medicated lambs passed fewer oocysts for a shorter period of time than lambs inoculated with normal oocysts. The former lambs gained more weight, passed better formed faeces, ate better and had higher PCV and haemoglobin values than the latter.

Observations on the blood of a tropical bat, Otomops martiensseni

SummaryObservations are reported on the composition of the blood of a tropical, cave‐dwelling bat, Otomops martiensseni. The most remarkable feature of the blood was the very high numbers of erythrocytes, with mean values of 14–42 times 106 and 12–46 times 106 cells per mm3 of blood, for female and male bats respectively. The red cells were spherical, biconcave discs with a mean diameter of 5‐3 um, a mean thickness of 1–8 urn and a mean volume of 40‐7 μm3. High haemoglobin values were obtained, with means of 20–70 and 18‐15 g per 100 ml of blood, for female and male bats respectively. The leucocyte count varied from 1360 to 5200 cells per mm3 of blood and was rather lower than in other mammals.Electrophoresis of serum gave six protein fractions which were identified as albumin and α1α2, β1β2 and γ globulins.

Ovarian carcinoma--a 10-year series from a provincial hospital.

74 cases of ovarian carcinoma diagnosed and treated at the department of obstetrics and gynaecology, Helsingborg's hospital during the years 1956‐1965 were examined with special reference to the effect of various biological, social and clinical factors on the later course. The following features were associated with a more favourable prognosis: younger age groups; married women; high haemoglobin values; short duration of symptoms; uterine bleeding as first symptom; low stage of tumour; mucinous cystocarcinoma; and following tumour characteristics: unilateral tumour; unruptured tumour; non‐adherent tumour; absence of metastases; absence of ascites. The differences regarding the 5‐year survival rate were found to be statistically significant within the groups relating to age, haemoglobin value, stage and the variables given under “tumour characteristics” (with the exception of “unruptured tumour”). The patient's parity and the size of the tumour was of little or no prognostic value in the present series. The prognosis was significantly better for patients who had bilateral oophorectomy combined with hysterectomy, than for those who had bilateral oophorectomy alone. The total 5‐year survival rate was 35.1%. 6‐16 years after the diagnosis 29.7% of the patients were still alive, 5.4% had died from intercurrent diseases and 64.9% from the tumour.