Chen Junchen, Li Yi, Cui Heng
Center of Gynecologic Oncology, Peking University People's Hospital, Beijing, China.
Department of Obstetrics and Gynecology, Peking University People's Hospital, No. 11, Xi-Zhi-Men South Street, Xi Cheng District, Beijing, 100044, China.
Arch Gynecol Obstet. 2021 Mar;303(3):767-775. doi: 10.1007/s00404-020-05822-w. Epub 2020 Oct 3.
The study aimed to investigate the prognostic value of preoperative hematocrit (HCT) on the survival of epithelial ovarian cancer (EOC) patients.
Patients who underwent primary debulking surgery (PDS) in our institution, from January 2010 to December 2015, were enrolled. The preoperative HCT, hemoglobin (Hb), tumor stage, ascites volume, age, albumin, BMI, ASA score, diabetes and other factors were collected and analyzed to find the risk factors for poor prognosis of EOC patients using Cox regression. Survival analysis was conducted with Kaplan-Meier method and log-rank test.
192 patients met the inclusion criteria. HCT < 35% (P = 0.031, HR: 1.715, 95% CI 1.050-2.802) was an independent risk factor for poor overall survival in patients. The mean survival time was 83.7 months in patients with preoperative HCT ≥ 35% and 61.7 months in patients with HCT < 35% (P = 0.002). Patients with low HCT (< 35%) had a poor prognosis compared with patients with normal HCT, specifically in the patients of stage III/IV, age ≥ 65 years, BMI ≥ 25.0 kg/m, ascites volume ≤ 500 mL, ASA score < 3, albumin ≥ 35 g/L and nondiabetic. Low HCT was more likely to occur in patients with advanced stage (III/IV), anemia (Hb < 110 g/mL), low albumin (< 35 g/L), high ASA score (≥ 3) and platelet > 400 × 10/L.
Preoperative low HCT was a valuable predictor for EOC patients' poor prognosis, specifically in obese, nondiabetic, elder, advanced stage but having relatively good performance status patients.
本研究旨在探讨术前血细胞比容（HCT）对上皮性卵巢癌（EOC）患者生存的预后价值。
纳入2010年1月至2015年12月在我院接受初次肿瘤细胞减灭术（PDS）的患者。收集术前HCT、血红蛋白（Hb）、肿瘤分期、腹水体积、年龄、白蛋白、体重指数、美国麻醉医师协会（ASA）评分、糖尿病及其他因素，并进行分析，采用Cox回归分析寻找EOC患者预后不良的危险因素。采用Kaplan-Meier法和对数秩检验进行生存分析。
192例患者符合纳入标准。HCT＜35%（P = 0.031，HR：1.715，95%CI 1.050 - 2.802）是患者总体生存不良的独立危险因素。术前HCT≥35%的患者平均生存时间为83.7个月，HCT＜35%的患者为61.7个月（P = 0.002）。与HCT正常的患者相比，HCT低（＜35%）的患者预后较差，特别是在Ⅲ/Ⅳ期、年龄≥65岁、体重指数≥25.0 kg/m、腹水体积≤500 mL、ASA评分＜3、白蛋白≥35 g/L且无糖尿病的患者中。HCT低更易发生于晚期（Ⅲ/Ⅳ期）、贫血（Hb＜110 g/mL）、白蛋白低（＜35 g/L）、ASA评分高（≥3）和血小板＞400×10⁹/L的患者。
术前低HCT是EOC患者预后不良的重要预测指标，特别是在肥胖且无糖尿病、年龄较大、处于晚期但一般状况相对较好的患者中。
