Pre-chemotherapy hemoglobin levels and survival in patients with advanced epithelial ovarian cancer who received a first-line taxane/platinum-based regimen: results of a multicenter retrospective Italian study

OBJECTIVE: The aim of this retrospective multicenter study was to assess whether the pre-chemotherapy hemoglobin levels have any impact on the clinical outcome of patients with advanced epithelial ovarian cancer who received a first-line taxane/platinum-based regimen. METHODS: The study was conducted on 315 patients who underwent initial surgery followed by taxane/platinum-based chemotherapy for FIGO stage IIc-IV epithelial ovarian cancer. All the patients had ECOG performance status 0-1 at presentation. The median follow-up of survivors was 36 months (range, 6-120 months). RESULTS: The 25%, 50%, and 75% quantiles of hemoglobin levels before starting first-line chemotherapy were 10.2, 11.4, and 12.3 g/dl, respectively. Residual disease after initial surgery (>1 cm versus </= 1 cm, P = 0.0013) was the only independent prognostic variable for overall survival. Conversely, hemoglobin levels (<10.2 g/dl versus 10.2-11.4 g/dl versus 11.5-12.3 g/dl versus >12.3 g/dl) were inversely related to overall survival at univariate (P = 0.03) but not at multivariate analysis. CONCLUSIONS: This investigation showed that hemoglobin levels before starting first-line taxane/platinum-based chemotherapy are not an independent prognostic factor for overall survival in patients with advanced epithelial ovarian cancer.