Hematological and Clinical Predictors of Survival in Cervical Cancer Patients in Nigeria: A Retrospective Cohort Study

Background: Cervical cancer remains a leading cause of cancer mortality in low-resource settings. Hematological abnormalities such as anemia and leukocytosis are common and may influence prognosis. Objective: To evaluate baseline hematological profiles and their association with overall survival among cervical cancer patients treated at the Radiotherapy Clinic, University College Hospital, Ibadan, Nigeria. Methods: A retrospective cohort study of 344 patients with histologically confirmed cervical cancer treated between 2003 and 2013 was conducted. Baseline hematological parameters included hemoglobin (Hb) level, white blood cell (WBC) count, and platelet count. Survival was analyzed using Kaplan–Meier method with log-rank tests. Independent predictors of survival were determined using Cox proportional hazards regression. Results: Median overall survival was 203 weeks (≈3.9 years). On Kaplan–Meier analysis, anemia (p = 0.026), leukocytosis (p = 0.001), stage at presentation (p = 0.003), and treatment status (p < 0.001), significantly influenced survival. In multivariate Cox regression, leukocytosis (aHR = 1.52, 95% CI: 1.06–2.18, p = 0.024), advanced stage (aHR = 1.56, 95% CI: 1.07–2.28, p = 0.022), and lack of treatment (aHR = 0.22, 95% CI: 0.13–0.39, p < 0.001) were independent predictors of mortality, while anemia was not independently significant. Conclusion: Leukocytosis, advanced stage, and treatment status are independent predictors of survival in cervical cancer patients, whereas anemia is associated with survival on univariate analysis only. Routine hematological assessment remains valuable for risk stratification in resource-limited settings.