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30 March 2009

Prognostic impact of hemoglobin levels before and during carboplatin/taxane-based chemotherapy in patients with primary invasive epithelial ovarian cancer

Michael H.R. EichbaumACDEF, Luise M.E. WeissABCDEF, Thomas BrucknerC, Andreas SchneeweissDE, Hans-Peter SinnBDE, Gerhard GebauerE, Nikos FersisE, Julia KussmaulDE, Christof SohnADE

Med Sci Monit 2009; 15(4): CR156-163 :: ID: 869615

Abstract

Background
Carboplatin/taxane-based chemotherapy is the standard treatment for advanced primary ovarian cancer. Anemia is a frequent side effect of platinum-containing chemotherapy regimens. Furthermore, ovarian cancer is often associated with tumor anemia. The aim of this study was to evaluate the prognostic relevance of the mean hemoglobin level before and during carboplatin/taxane-based chemotherapy.
Material and Method
We studied retrospectively 92 patients with primary invasive epithelial ovarian cancer (EOC) receiving carboplatin/taxane-based chemotherapy. Hemoglobin levels were determined before each cycle of therapy. Study objectives were progression-free survival time (PFS) and overall survival time (OS). Univariate analyses and Cox-regression studies were undertaken to evaluate the prognostic impact of hemoglobin levels before and throughout chemotherapy. In addition, sensitivity/specificity analyses and Kaplan-Meier-studies were performed to determine the cut-off level of prognostically relevant hemoglobin levels.
Results
In univariate analysis hemoglobin levels throughout chemotherapy showed prognostic relevance in terms of PFS (p<0.05). Sensitivity/specificity and Kaplan-Meier analyses found a hemoglobin level of 11.2 g/dL to be a prognostically relevant cut-off level in terms of PFS (p<0.05). There was a borderline significance for pretherapeutic hemoglobin levels to influence PFS (p=0.07), with a prognostically relevant cut-off level of 11.6 g/dL (p=0.06).
Conclusions
Hemoglobin levels before and particularly throughout therapy seem to have prognostic relevance for patients with primary EOC undergoing carboplatin/taxane-based chemotherapy. Further trials are required to confirm these data in a prospective attempt and to evaluate the role of correcting anemia as standard supportive therapy in the treatment of patients with primary EOC.

Keywords: Survival Analysis, Sensitivity and Specificity, Ovarian Neoplasms - pathology, Prognosis, Neoplasms, Glandular and Epithelial - pathology, Hemoglobins - analysis, Carboplatin - administration & dosage, Antineoplastic Combined Chemotherapy Protocols - therapeutic use, Aged, 80 and over, Adolescent, Taxoids - administration & dosage, young adult

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750