J Cancer 2018; 9(1):64-70. doi:10.7150/jca.22234

Research Paper

Monocytosis as a prognostic factor for survival in stage IB and IIA cervical cancer

Wan Kyu Eo1*, Byung Su Kwon2*, Ki Hyung Kim2✉, Heung Yeol Kim3✉, Hong-bae Kim4, Suk Bong Koh5, Sungwook Chun6, Yong Il Ji6, Ji Young Lee7, Jeong Namkung8, Sanghoon Kwon9

1. Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea.
2. Department of Obstetrics and Gynecology, Pusan National University School of Medicine; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
3. Department of Obstetrics and Gynecology, College of Medicine, Kosin University, Busan, Korea.
4. Department of Obstetrics and Gynecology, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Korea.
5. Department of Obstetrics and Gynecology, Catholic University of Daegu, School of Medicine, Daegu, Korea.
6. Department of Obstetrics and Gynecology, College of Medicine, Inje University, Busan, Korea.
7. Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea.
8. Department of Obstetrics and Gynecology, Catholic University, Seoul, Republic of Korea.
9. Department of Obstetrics and Gynecology, Keimyung University, School of Medicine, Daegu, Korea
*Eo WK and Kwon BS equally contributed to this article for first author.

Abstract

Objective: To measure hematologic parameters derived from the white blood cell (WBC) count and differential count (DC) as prognostic factors for survival in patients with stage IB and IIA cervical cancer.

Methods: We retrospectively examined demographic, clinicopathologic, and laboratory parameters in a cohort of 233 patients with International Federation of Gynecology and Obstetrics stage IB and IIA cervical cancer who underwent surgical resection. We further assessed the effects of the WBC count and DC-derived hematologic parameters on progression-free survival (PFS) and overall survival (OS) after controlling for other parameters.

Results: Patients were followed up for a median of 46.6 months (range, 9-142 months). The Kaplan-Meier estimates of PFS and OS at 5 years were 88.5% and 92.3%, respectively. In a multivariate analysis, we identified the absolute monocyte count (AMC) (hazard ratio [HR], 11.78; P <0.001) and tumor size (HR, 5.41; P = 0.003) as the strongest prognostic factors affecting PFS. We also identified AMC (HR, 23.29; P <0.001), tumor size, (HR, 5.27; P = 0.033), and lymph node involvement (HR, 3.90; P = 0.027) as the strongest prognostic factors affecting OS. AMC remained prognostic with respect to PFS or OS in a Cox model that controlled for the neutrophil-lymphocyte ratio or lymphocyte-monocyte ratio, although neither ratio was a significant prognostic factor for survival.

Conclusions: Monocytosis and an increased tumor size were found to be independent prognostic factors affecting both PFS and OS in patients with stage IB and IIA cervical cancer.

Keywords: Monocytes, Uterine cervical neoplasms

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How to cite this article:
Eo WK, Kwon BS, Kim KH, Kim HY, Kim Hb, Koh SB, Chun S, Ji YI, Lee JY, Namkung J, Kwon S. Monocytosis as a prognostic factor for survival in stage IB and IIA cervical cancer. J Cancer 2018; 9(1):64-70. doi:10.7150/jca.22234. Available from http://www.jcancer.org/v09p0064.htm