The effect of surgical interventions for gynaecological malignancies on red blood cell indices and hemostaseologic parameters

The goal of this study was to monitor changes of common hemostaseologic parameters, serum protein concentration red blood cell (RBC) indices and erythrocyte sedimentation rate (ESR) in women with malignant and non-malignant gynecologic disease preoperatively and in the early postoperative period (five days).One hundred fifty-two women with a primary diagnosis of gynaecological malignancy and a matched group of women undergoing surgery for non-malignant disorders were enrolled in the study. Patients with severe comorbity or venous thrombosis events in the recent history (< six months) were excluded. Preoperatively, coagulation markers including fibrinogen- and D-Dimer-levels were statistically significantly higher, while pTTT was prolonged in all cancer patients compared to the benign tumor patients. Mean albumin/globulin ratio (A/G-R) was lower in each of the cancer types being lowest in ovarian cancer patients while RBC indices (MCH, MCV, and MCHC) were comparable with those of the benign disease group. However, ESR was significantly higher in all types of cancer compared to the controls. Postoperatively, in the cancer groups, mean values of coagulation markers increased and remained significantly higher as compared to the preoperative values until day 5. A/G-R slightly but statistically significantly dropped postoperatively, being lowest in patients with ovarian cancer. While in the cancer patients, ESR statistically significantly increased postoperatively and remained high until day 5 it remained unchanged after surgery for benign disease. The preoperative use of common routine laboratory markers may allow differentiation of dignity in patients with benign and malign gynecologic disease. Moreover, the divergence of the results postoperatively correlate with the extent of the intervention and the tumor load being most remarkable after ovarian cancer surgery.