SUMMARY 205 9 space invasion and FIGO staging were independently associated for reduced diseasespecific survival. Hormone expression of 90-100% and POLE mutation were independently associated with improved disease-specific survival. In Chapter 7, the prognostic and predictive value of preoperative abnormal hematologic parameters (anemia, thrombocytosis and leukocytosis) was determined among 894 patients with EC. Patients with anemia had significantly reduced 5-year disease-specific and recurrence-free survival and patients with thrombocytosis a reduced 5-year diseasespecific survival. In multivariate analysis, anemia, age and the ESGO/ESTRO/ESP ‘high and advanced/metastatic’ risk group were found to be independently associated with reduced disease-specific survival. Within patients who received adjuvant radiotherapy (n=239) preoperative anemia was found to be significantly associated with decreased disease-specific and recurrence-free survival. Patients with preoperative anemia within the ESGO/ESTRO/ ESP ‘intermediate’ risk group who had received vaginal brachytherapy, showed significantly reduced disease-specific survival. It was concluded that preoperative anemia can possibly be considered as a prognostic marker and probably also as a predictive marker in response to radiotherapy. In Chapter 8, the studies in this thesis are discussed and put into perspective with the most recent findings in literature. Finally, results are translated into clinical recommendations and a diagnostic decision tree to optimize individualized care of patients with endometrial carcinoma.
RkJQdWJsaXNoZXIy MTk4NDMw