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Prognostic impact of neutrophilia and lymphopenia on survival in anal cancer treated with definitive concurrent chemoradiotherapy: a retrospective multicenter study
- Title
- Prognostic impact of neutrophilia and lymphopenia on survival in anal cancer treated with definitive concurrent chemoradiotherapy: a retrospective multicenter study
- Authors
- Kim E.; Kim T.H.; Jung W.; Kim K.; Chang A.R.; Park H.J.; Koh H.K.; Hong S.; Kim K.H.; Chang J.S.; Koom W.S.; Jang W.I.; Kim M.-S.
- Ewha Authors
- 김규보
- SCOPUS Author ID
- 김규보
- Issue Date
- 2022
- Journal Title
- International Journal of Clinical Oncology
- ISSN
- 1341-9625
- Citation
- International Journal of Clinical Oncology vol. 27, no. 3, pp. 553 - 562
- Keywords
- Anal squamous cell carcinoma; Chemoradiotherapy; Lymphopenia; Neutrophilia; Survival
- Publisher
- Springer Japan
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Purpose: This study evaluated the prognostic value of leukocyte, lymphocyte, and neutrophil counts in anal cancer patients undergoing concurrent chemoradiotherapy (CCRT). Methods: Multi-institutional retrospective data review included 148 non-metastatic anal cancer patients treated with definitive CCRT with 5-fluorouracil plus mitomycin C between the year 2001 and 2019. The median radiation dose to the primary tumor was 54 Gy with a median pelvic dose of 45 Gy. Median follow-up duration was 56 months, and complete blood cell counts were analyzed from baseline to 1 year after the completion of radiotherapy. Results: Although most patients showed a normal number of blood cells before treatment, 6.1% and 4.1% of patients showed leukocytosis (> 10,000/μl) and neutrophilia (> 7500/μl), respectively. After the initiation of treatment, seven patients (4.7%) displayed grade 4 lymphopenia (< 200/μl) at 1 month. Patients with initial leukocytosis showed inferior progression- and locoregional progression-free survival, and neutrophilia was a prognostic factor in all survival outcomes. Grade 4 lymphopenia at 1 month was also significantly associated with overall, progression-, and distant metastasis-free survival. On multivariate analyses, baseline neutrophilia was associated with 56.8-, 22.6-, 10.7-, and 23.0-fold increased risks of death, disease relapse, locoregional progression, and distant metastasis, respectively. Furthermore, lymphocytes < 200/μl at 1 month was linked to 6.8-, 5.4-, and 6.3-fold increased risks for death, disease relapse, and distant metastasis, respectively. Conclusion: The number of leukocytes, lymphocytes, and neutrophils readily acquired from routine blood tests before and during treatment could be an independent prognostic factor of survival in patients with anal cancer. © 2021, The Author(s) under exclusive licence to Japan Society of Clinical Oncology.
- DOI
- 10.1007/s10147-021-02094-5
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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