Is chemotherapy-induced neutropenia a prognostic factor in patients with ovarian cancer?


Jong-Hyeok Kim, Department of Obstetrics and Gynecology, University of Ulsan, College of Medicine, Asan Medical Center, Asanbyeongwon-gil 86, Songpa-gu, Seoul 138-736, Korea. E-mail:


Objective. This study sought to determine if relative neutropenia (RN) following six cycles of paclitaxel/carboplatin could serve as a prognostic factor in patients with ovarian cancer. Design. A single institution, retrospective study. Setting. Tertiary academic referral center, Seoul, Korea Population. A total of 179 patients who underwent primary cytoreductive surgery, followed by six cycles of paclitaxel/carboplatin chemotherapy to treat epithelial ovarian cancer. Methods. Relative neutropenia was defined by an absolute neutrophil count < 1000 neutrophils/mm3 at chemotherapy cycle nadir. To eliminate the effects of dose reduction (DR) and schedule delay (SD) on the outcome of analysis, 49 patients who had this were excluded, and a subset analysis of 130 patients who received standard doses and schedules of chemotherapy was performed. Main outcome measures. Progression free and overall survival. Results. The median progression free survival (PFSs) of neutropenic and non-neutropenic patients was 34 and 22 months, respectively; the median overall survival (OS) times were 67 and 56 months, respectively, with no significant differences in PFS and OS (p = 0.26, 0.59). Multivariate analysis revealed that stage, clear cell histology, and ≥1 cm residual tumor mass were independent prognostic predictors, while RN was not. In the subset analysis confined to the patients without DR and SD, the results were not changed. Conclusion. Chemotherapy-induced neutropenia was not a significant prognostic indicator in ovarian cancer patients treated with paclitaxel/carboplatin as first-line chemotherapy.