Tumor Anemia and Thrombocytosis in Patients with Vulvar Cancer

Abstract

The aim of our study was to determine the prevalence of tumor anemia and thrombocytosis in patients with vulvar cancer, and to evaluate the prognostic value or pretreatment hemoglobin (Hb) and platelet count regarding disease-free and overall survival of patients with vulvar cancer. We measured pretreatment Hb and platelet count in 62 patients with squamous cell vulvar cancer. The results were correlated to clinical data. Median Hb and platelet count in patients with vulvar cancer were 13.1 g/dl (range 8.3–16.2) and 268,500/μl (range 88,000–778,000), respectively. Cut-off levels of 12 g/dl and 300,000/μl were selected for tumor anemia and tumor thrombocytosis, respectively according to published criteria. Tumor anemia and tumor thrombocytosis were present in 30.6 and 27.4% of patients with vulvar cancer, respectively. In a univariate analysis tumor stage and tumor thrombocytosis were significantly associated with a shortened disease-free (log-rank test, p < 0.001 and p = 0.003, respectively) and overall survival (log-rank test, p < 0.001 and p < 0.001, respectively). Tumor anemia was not associated with a shortened disease-free, but with a shortened overall survival of patients with vulvar cancer (log-rank test, p = 0.1 and p = 0.002, respectively). A multivariate Cox regression model considering tumor stage, tumor anemia, and tumor thrombocytosis showed, however, that pretreatment Hb and platelet count did not confer additional prognostic information to that already obtained by the established prognosticator tumor stage on disease free (multivariate Cox regression model, p = 0.8, p = 0.2, and p = 0.003, respectively) and overall survival (multivariate Cox regression model, p = 0.4, p = 0.5, and p = 0.04, respectively). Pretreatment tumor anemia and tumor thrombocytosis were associated with a poor prognosis, but were not an independent predictor of outcome in patients with vulvar cancer.

Preoperative Thrombocytosis and Poor Prognostic Factors in Endometrial Cancer

“…However, there have been evidences that the tumor cells secrete humoral factors which may eventually lead to thrombocytosis (Nakazaki, 1992;Lidor et al, 1993;Kabir and Darr, 1995;Wu et al, 1996). Preoperative thrombocytosis has also been observed and found to be a poor prognostic variable in gynecological malignancies including vulvar, cervical, ovarian, and endometrial cancers (Hernandez et al, 1992;Zeimet et al, 1994;Menczer et al, 1996;Gucer et al, 1998;Hefler et al, 2000;Hernandez et al, 2000;Scholz et al, 2000;Tamussino et al, 2001;Li et al, 2004;Ayhan et al, 2006;Metindir and Dilek, 2009).…”

Preoperative Platelet Count and Survival Prognosis in Resected Pancreatic Ductal Adenocarcinoma

“…Platelets play an important role in angiogenesis and proteolysis of the basal membrane, and both situations are present in the process of tumor growth and metastatic spread [7]. Some studies have found that thrombocytosis is associated with poor survival in renal [8][9][10][11][12][13], gynecologic [14][15][16][17][18][19][20][21], and lung tumors [22,23]. Thrombocytosis has also been evaluated in pancreatic carcinoma, but the number of patients studied is small and the results are conflicting [24][25][26].…”

The prognostic significance of thrombocytosis in ovarian cancer

“…An increased platelet count is associated with tumours of the organs of the minor pelvis and beyond [5]. Increased thrombocytosis is found in 30-60% of patients with non-gynaecological neoplasms, and in 10-30% of patients with neoplasms of the reproductive system including ovarian cancer, vulvar cancer [6], cervical cancer and endometrial cancer [7]. Many research papers have presented contradictory findings on the significance of thrombocytosis as a diagnostic and prognostic parameter in ovarian cancer.…”