Prognostic Significance of Hemoglobin Levels in Patients with Primary Epithelial Ovarian Carcinoma Undergoing Platinumbased Chemotherapy

Abstract

The aim of this study was to evaluate the prognostic impact of hemoglobin (Hb) levels before and throughoutthe course of platinum-based chemotherapy in patients with primary epithelial ovarian cancer (EOC). Medicalrecords of patients who had undergone initial surgery followed by platinum-based chemotherapy for EOC wereretrospectively studied. Univariate and Cox-regression models were used to evaluate the prognostic impact ofvarious factors including Hb levels before and throughout chemotherapy in terms of overall survival. Additionally,sensitivity/specificity were calculated using receiver operating curves (ROCs) and Kaplan-Meier studies wereused to determine optimal cut-off levels. The median duration of follow-up was 37.0 months. Degree of anemiabefore starting chemotherapy was significantly related to overall survival (p = 0.001), but the Hb level throughoutchemotherapy demonstrated only a borderline relationship (p = 0.062). Only residual tumor after surgery anddegree of anemia before starting chemotherapy proved to be independent prognostic factors (p = 0.013 and 0.015,respectively). With sensitivity/specificity and Kaplan-Meier analyses, a Hb level before starting chemotherapyof less than 10.5 g/dl was related to shorter overall survival (p = 0.002). In conclusion, pre-chemotherapy Hblevel has a prognostic impact on overall survival in patients with EOC candidate to first-line platinum-basedchemotherapy. However, the significance of decreased Hb levels during chemotherapy needs to be clarified infurther prospective studies to determine optimal Hb levels for achieving a favorable outcome.