CHAPTER 7 164 second analysis. To further refine response of RT and in order to prevent treatment bias by including patients who were not treated according to the recent guideline, patients classified as ESGO/ESTRO/ESP intermediate risk were only included (flowchart secondary analysis Figure S1). According to the guideline, these patients are recommended to receive adjuvant vaginal brachytherapy (VBT)7, whereas other risk classification groups include observation or combined chemoradiotherapy. For statistical analyses, Statistical Package for the Social Sciences, version 25.0 (IBM, New York, NY, USA) was applied. The results were considered significant with P-value less than 0.05 (P<0.05). Clinicopathological characteristics between dichotomous haematological subgroups were compared using the χ2 or Fisher’s exact test for categorical data, and the nonparametric Mann-Whitney U-test for continuous variables. Association between exposure and outcome are shown as odds ratio (OR), 95% Confidence Interval (CI) and P-value. Survival analyses were performed using Kaplan-Meier curves and univariable and multivariable Cox-regression. Associations are shown as hazard ratio (HR), 95% CI and P-value. Diseasespecific survival (DSS) was defined as time from date of diagnosis to date of death by EC and recurrence-free survival (RFS) was defined as time from surgery to time of recurrence from EC disease, all censored by date of last contact. Within the survival analysis, patients with abnormal haematological parameters and an increased or reduced/decreased DSS or RFS were compared to the reference group, patients with normal haematological parameters. RESULTS Patients A total of 896 EC patients were included with a least one haematological parameter. Two patients had abnormally high leukocyte count (>50x109/L) due to chronic lymphatic leukaemia and unknown cause, these patients were excluded, resulting in 894 EC patients (54.8% British and 45.2% Dutch) included in this study with a median follow-up of 4.5 years (range 0-10 years) (Figure 1). Clinicopathological characteristics of the study cohort are shown in Table 1. Median age was 65.9 (27.2-93.8) years and median body mass index 29.7 (16.4-60.9) kg/ m2. Of 653 (73.0%) EC patients all three haematological parameters were available. Median preoperative haemoglobin level was 8.4 mmol/L, median platelet count 298.3x109 platelets/L and median leukocyte count 8.1x109/L. Anaemia was present in 103 (11.3%), thrombocytosis in 79 (8.6%) and leucocytosis in 114 patients (12.5%). Most patients were diagnosed with low-grade (grade 1-2), FIGO stage I-II and endometrioid EC (respectively, 69.4%, 90.2% and 82.2%). Lymphadenectomy was performed in 205 patients (22.9%) of whom 34 (16.5%) had lymph node metastasis. Adjuvant treatment was administered in 344 patients (38.5%). A total of 239 patients (69.5%) received RT of which 132 patients (55.2%) VBT and 107
RkJQdWJsaXNoZXIy MTk4NDMw