Abstract | BACKGROUND: There are emerging data showing the prognostic significance of pretreatment leukocytosis in patients with cervical cancer; it is generally associated with adverse outcome. However, the prognostic impact of leukocytosis in patients with anal cancer has not been previously reported. OBJECTIVE: DESIGN: This is a retrospective cohort study. SETTING AND PATIENTS: MAIN OUTCOME MEASURES: The primary outcomes were disease-free and overall survival. RESULTS: Median follow-up was 24 months. Pretreatment leukocytosis (white blood cell count >10 × 10/L) was identified in 15.9% (20/126) of patients. After adjusting for sex, tumor size, and stage in a multivariate analysis, leukocytosis remained significantly associated with worse disease-free survival (HR, 2.2; 95% CI, 1.1-4.8; p = 0.045) and worse overall survival (HR, 2.9; 95% CI, 1.1-7.9; p = 0.036). Patients with both leukocytosis and anemia (pretreatment hemoglobin <125 g/L) had the worst prognosis: 2-year disease-free survival 42.1% versus 72.9% for patients without these factors (HR, 2.7; 95% CI, 1.1-6.8; p = 0.033); 2-year overall survival 60.9% versus 89.8% (HR, 4.5; 95% CI, 1.5-13.2; p = 0.006). LIMITATIONS: The study was limited by its retrospective nature and lack of patients with multiple hematologic abnormalities (ie, both anemia and leukocytosis). HIV status was unable to be evaluated. CONCLUSIONS: Pretreatment leukocytosis in patients with anal cancer is associated with significantly worse disease-free and overall survival, which appears to be exacerbated with the presence of pretreatment anemia.
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Authors | Robyn Banerjee, George Roxin, Misha Eliasziw, Kurian Joseph, Anthony Maclean, W Donald Buie, Corinne Doll |
Journal | Diseases of the colon and rectum
(Dis Colon Rectum)
Vol. 56
Issue 9
Pg. 1036-42
(Sep 2013)
ISSN: 1530-0358 [Electronic] United States |
PMID | 23929012
(Publication Type: Evaluation Study, Journal Article, Multicenter Study)
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Topics |
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Anus Neoplasms
(complications, mortality, therapy)
- Carcinoma, Adenosquamous
(complications, mortality, therapy)
- Carcinoma, Squamous Cell
(complications, mortality, therapy)
- Chemoradiotherapy
- Female
- Follow-Up Studies
- Humans
- Leukocytosis
(diagnosis, etiology)
- Male
- Middle Aged
- Multivariate Analysis
- Prognosis
- Retrospective Studies
- Survival Analysis
- Treatment Outcome
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