CHAPTER 7 162 on RT response.10 So far, no studies reported the impact of thrombocytosis on RT in solid tumours. Based on conflicting results in outcome of abnormal preoperative haematological parameters in EC, we aim to evaluate the prognostic relevance of anaemia, thrombocytosis and leucocytosis on survival. Second, we aim to explore the predictive relevance of these abnormal haematological parameters on response to adjuvant RT. We hypothesize that patients with anaemia, thrombocytosis and/or leucocytosis have reduced survival due to advanced-stage EC, and anaemia might have negative impact on response to adjuvant RT. MATERIAL AND METHODS Study cohort A multicentre cohort study was performed with a combination of prospective and retrospectively collected data in patients diagnosed with EC. This study is a collaboration between the Netherlands and the United Kingdom (UK) by which data of nine hospitals in the Netherlands (PIpelle Prospective ENDOmetrial carcinoma (PIPENDO) cohort25) and one in the UK26 were merged. The design and patient cohort of both cohorts, including 946 patients in total (PIPENDO and UK), have been published previously.25, 26 A study flowchart is shown in the Figure 1. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline. Data collection All patients were surgically treated between 2006-2015. For the Dutch participating hospitals patient characteristics, postoperative tumour histology, grade and FIGO staging were collected prospectively.25 Preoperative haemoglobin level, platelet- and leukocyte counts were collected retrospectively from hospital records. For the UK centre, all clinicopathological characteristics and preoperative haematological parameters were collected retrospectively.26 Regarding to the data collection of nodal status, in the Netherlands and UK surgical staging is selectively performed in patients with preoperative high-grade histology (grade 3 endometrioid EC and non-endometrioid EC) and in case of clinical suspicion of extended disease, according to the Dutch and British EC guideline.27, 28 The sole additional inclusion criteria used for this study was that patients were only included if at least one of the three preoperative haematological parameters was conducted ≤ 6 weeks prior to surgery, resulting in 896 patients.
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