Anaemia associated with reduced response to radiotherapy in endometrial cancer patients, reports study

Recent study aimed to evaluate the prognostic relevance of anaemia, thrombocytosis, and leucocytosis in endometrial cancer (EC) and explore their predictive relevance in response to adjuvant radiotherapy. A retrospective multicenter cohort study was conducted, including 894 patients with a median follow-up of 4.5 years. The presence of anaemia or thrombocytosis was significantly associated with higher ESGO/ESTRO/ESP risk groups. Anaemia was independently associated with decreased disease-specific survival and reduced response to adjuvant radiotherapy. In patients receiving adjuvant radiotherapy, anaemia was associated with significantly reduced 5-year disease-specific and recurrence-free survival. In patients classified as ESGO/ESTRO/ESP intermediate risk and receiving solely vaginal brachytherapy, anaemia was associated with reduced disease-specific survival. The results indicate that anaemia is an independent prognostic factor in EC and may be a predictive biomarker for reduced response to radiotherapy. Thrombocytosis and leucocytosis did not significantly impact the response to radiotherapy.

Associations with Anaemia, Thrombocytosis, and Leucocytosis

The study demonstrated that patients with anaemia were significantly associated with higher ESGO/ESTRO/ESP risk groups, grade 3 EC, and lymphovascular space invasion. Moreover, anaemia was identified as an independent prognostic factor for disease-specific survival, indicating its potential as a predictive biomarker for response to adjuvant radiotherapy. Thrombocytosis and leucocytosis did not show independent associations with decreased disease-specific or recurrence-free survival.

Implications for Treatment and Validation Needs

The findings suggest that preoperative anaemia, thrombocytosis, and leucocytosis may reflect tumor aggressiveness and have implications for the response to adjuvant treatment. The study highlights the importance of understanding the prognostic and predictive relevance of these hematological parameters in EC, particularly in guiding treatment decisions and identifying patients who may benefit from personalized adjuvant therapy. The study also emphasizes the need for prospective validation in a larger study cohort to verify the potential of anaemia as a predictive biomarker for radiotherapy and to further evaluate its impact in addition to molecular subgroups.

The study contributes important insights into the prognostic and predictive relevance of preoperative hematological parameters in EC and underscores the potential value of anaemia as an independent prognostic factor and predictive biomarker for response to radiotherapy. The results suggest that further research is needed to elucidate the mechanisms behind the associations and to explore the impact of these parameters specifically in young women eligible for fertility-sparing strategies. Prospective studies are essential to validate the findings and further assess the clinical implications of these hematological parameters in EC.

Summary and Conclusion

In summary, the study provides valuable evidence supporting the independent prognostic relevance of anaemia in EC and its potential as a predictive biomarker for response to radiotherapy. The findings underscore the need for additional research to validate these results and to explore the significance of hematological parameters in guiding personalized treatment strategies for patients with EC.

Key Points

1. The study evaluated the prognostic relevance of anaemia, thrombocytosis, and leucocytosis in endometrial cancer (EC) and explored their predictive relevance in response to adjuvant radiotherapy. 2. Anaemia and thrombocytosis were significantly associated with higher ESGO/ESTRO/ESP risk groups and grade 3 EC, and anaemia was identified as an independent prognostic factor for decreased disease-specific survival, indicating its potential as a predictive biomarker for response to adjuvant radiotherapy.

3. In patients receiving adjuvant radiotherapy, anaemia was associated with significantly reduced 5-year disease-specific and recurrence-free survival. Similarly, in patients classified as ESGO/ESTRO/ESP intermediate risk and receiving solely vaginal brachytherapy, anaemia was associated with reduced disease-specific survival.

4. Thrombocytosis and leucocytosis did not show independent associations with decreased disease-specific or recurrence-free survival and did not significantly impact the response to radiotherapy.

5. The findings suggest that preoperative anaemia, thrombocytosis, and leucocytosis may reflect tumor aggressiveness and have implications for the response to adjuvant treatment, highlighting the importance of understanding the prognostic and predictive relevance of these hematological parameters in EC to guide treatment decisions and identify patients who may benefit from personalized adjuvant therapy.

6. The study provides evidence supporting the independent prognostic relevance of anaemia in EC and its potential as a predictive biomarker for response to radiotherapy, and further research is needed to validate these results and to explore the significance of hematological parameters in guiding personalized treatment strategies for patients with EC. Additionally, further research is suggested to elucidate the mechanisms behind the associations and to explore the impact of these parameters specifically in young women eligible for fertility-sparing strategies.

Reference –

Stephanie W. Vrede, Hannah Donkers, Casper Reijnen, Anke Smits, Nicole C.M. Visser, Peggy M. Geomini, Huy Ngo, Dennis van Hamont, Brenda M. Pijlman, Maria Caroline Vos, Marc P.L.M. Snijders, Roy Kruitwagen, Ruud L.M. Bekkers, Khadra Galaal & Johanna M.A. Pijnenborg (2024) Abnormal preoperative haematological parameters in Endometrial cancer; reflecting tumour aggressiveness or reduced response to radiotherapy?, Journal of Obstetrics and Gynaecology, 44:1, 2294332, DOI: 10.1080/01443615.2023.2294332.