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Preoperative Leukocytosis Imposes an Increased Risk of Recurrence and Death Among Patients With Nonendometrioid Endometrial Carcinoma
  1. Michael J. Worley, MD*,
  2. Caroline C. Nitschmann, MD,
  3. Melina Shoni, MD*,
  4. Jose Alejandro Rauh-Hain, MD,
  5. Kristina A. Williams, BS§ and
  6. Colleen M. Feltmate, MD*
  1. *Division of Gynecologic Oncology, and
  2. Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital;
  3. Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital; and
  4. §Harvard Medical School, Boston, MA.
  1. Address correspondence and reprint requests to Colleen Feltmate, MD, Division of Gynecologic Oncology, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115. E-mail:


Objective To evaluate the impact of preoperative leukocytosis among patients with nonendometrioid endometrial carcinoma.

Methods The medical records of all patients with nonendometrioid endometrial carcinoma who underwent surgical treatment between January 2005 and December 2010 were retrospectively reviewed. The patients were separated into 2 groups based on the presence or absence of preoperative leukocytosis (white blood cell count ≥10,000/μL). The groups were then compared with respect to pathologic findings, progression-free survival, and overall survival.

Results A total of 222 patients were identified, and preoperative leukocytosis was observed in 33 patients (14.9%). The leukocytosis group was associated with a larger mean size of the primary tumor (6.8 vs 4.6 cm, P = 0.016) and a greater percentage of patients with cervical stromal involvement (36.4% vs 20.1%, P = 0.039), adnexal involvement (42.4% vs. 22.8%, P = 0.017), and pelvic/para-aortic lymph node involvement (50% vs 27.4%, P = 0.025). On multivariate analysis, preoperative leukocytosis was independently associated with an increased risk of recurrence (hazard ratio, 2.07; 95% confidence interval, 1.12–3.84) and an increased risk of death (hazard ratio, 3.33; 95% confidence interval, 2.01–5.53).

Conclusions Among patients with nonendometrioid endometrial carcinoma, preoperative leukocytosis is independently associated with an increased risk of recurrence and death.

  • Nonendometrioid
  • Endometrial carcinoma
  • Preoperative leukocytosis

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  • The authors declare conflicts of interest.