The Prognostic Impact of Duration of Anemia During Chemotherapy in Advanced Epithelial Ovarian Cancer

Objective. To propose ameasure of anemia to be used as a prognostic factor for progression-free survival and overall survival in advanced epithelial ovarian cancer patients. Patients and Methods. Seventy-six patients with International Federation of Gynecology and Obstetrics stage III and stage IV epithelial ovarian cancer who had received at least six courses of platinum-and taxane-based systemic chemotherapy and achieved clinical or pathologic complete response were included. A novel prognostic factor based on the duration of anemia was proposed and the impact of anemia on progression-free and overall survival times was analyzed by a log-rank test and a Cox proportional hazards model. Results. We introduce a binary variable, Hb 1020, that takes a value of 1 if the duration of a hemoglobin (Hb) level <10 g/dL is >= 20% of the total duration of chemotherapy. We propose Hb1020 as a potential prognostic factor for epithelial ovarian cancer. The 5-year progression-free survival rates were 48.4% in the Hb1020 = 0 group (duration of Hb < 10 g/dL <20% of total duration) and 17.7% in the Hb1020 = 1 group (p=.026). The 5-year overall survival rates were 64.6% and 45.0%, respectively (p=.015). Conclusions. Hb1020, based on the duration of anemia, is a potential prognostic factor for epithelial ovarian cancer. Using Hb1020, we will be able to administer highly optimized treatment for anemia to improve patient survival. Further independent studies are needed to confirm its prognostic role. The Oncologist 2011; 16: 1154-1161