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Original Article
Neutrophilia and mortality in women with uterine carcinosarcoma
  1. Rebecca Arend1,
  2. Anne Van Arsdale2,
  3. Anar Gojayev3,
  4. Brandon Michael Roane1,
  5. David Doo1,
  6. Charles Leath1,
  7. Gary L Goldberg4 and
  8. Gloria Huang3
  1. 1 Gynecologic Oncology, University of Alabama at Birmingham, Birmingham, Alabama, United States
  2. 2 Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, United States
  3. 3 Yale School of Medicine and Yale Cancer Center, New Haven, Connecticut, United States
  4. 4 Northwell Health and Hofstra School of Medicine, New Hyde Park, New York, United States
  1. Correspondence to Dr Gloria Huang, Yale School of Medicine, New Haven, CT 06520, USA; gloria.huang{at}yale.edu

Abstract

Objective The objective of this study was to investigate the relationship between pre-treatment absolute neutrophil count and clinical outcomes in patients with uterine carcinosarcoma.

Methods In an Institutional Review Board approved, retrospective cohort study of 103 patients with uterine carcinosarcoma, the pre-treatment absolute neutrophil count data were obtained from the medical records, along with clinical, pathologic, treatment, and outcome data. Kaplan–Meier survival estimates were calculated and compared by the log rank test. Univariable and multivariable Cox proportional hazard regression models were used to examine the relationship of pre-treatment absolute neutrophil count with progression-free survival and overall survival.

Results Uterine carcinosarcoma patients in the highest quartile of pre-treatment absolute neutrophil count had significantly reduced progression-free survival (p<0.001, log rank test), and overall survival (p<0.001, log rank test), compared with patients in the lower absolute neutrophil count quartiles. On multivariable analysis, high absolute neutrophil count was an independent poor prognostic factor for disease recurrence, HR 2.97 (95% CI 1.35 to 6.53, p=0.007) for highest versus lowest quartile absolute neutrophil count, and for mortality, HR 4.43 (95% CI 1.64 to 12.00, p= 0.003).

Conclusions High pre-treatment absolute neutrophil count is an independent poor prognostic factor in patients with uterine carcinosarcoma and may be useful as a potential biomarker in clinical trials. The mechanistic relationship of neutrophilia and uterine carcinosarcoma progression merits further investigation.

  • carcinosarcoma
  • uterine cancer
  • preoperative care

https://doi.org/10.1136/ijgc-2019-000440

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    Footnotes

    • RA and AVA contributed equally.

    • Contributors RA and DD developed the study cohort and acquired the data; AVA developed the statistical models and performed the analyses; AG reviewed the literature; CL, BMR, and GLG edited the manuscript; GH conceptualized and supervised the study, and wrote the manuscript. All authors approved the manuscript.

    • Funding This study was funded by National Institutes of Health (NIH) Clinical Center 3P30CA013148-43S3, U10 CA180855, and K12HD001258-1, American Association of Obstetricians and Gynecologists Foundation.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available in a public, open access repository.